For Provider Organizations

Healthcare Provider Organizations

In today’s complex and highly regulated health care environment, maintaining profitability and compliance while continuing to ensure that all patients get the best care is no easy task. At PCG, we can help your organization understand changes in state and national policy reform and more effectively manage state programs, including Medicaid and Medicare.

Services include

Cost Reporting and Cost Settlement

  • EMS Supplemental Payment Program
  • Public and Private Health Facilities
  • School-Based Health Medicaid Cost Reporting and Cost Settlement

Delivery System Reform, Performance Management, And Quality Improvement

PCG provides our health care customers with delivery system reform, quality and performance improvement, and other technical advisory services related to state health reform efforts.  Our clients range from Medicaid agencies, to hospital systems, to community based providers.

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DSH Payment Management

Health Information Technology (HIT)

Within the PCG Health practice area, the Health Information Technology (HIT) team works with state and government agencies, with a focus on Medicaid, Exchanges and health information technology, to help further the advancement of technology in the world of health care.

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Healthcare Access and Markets

States regulate their private insurance markets and operate Medicaid managed care and fee-for-service programs to assure healthcare access to residents. This includes access to both physical and behavioral healthcare. States turn to PCG to organize their commercial health insurance regulatory compliance.

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Integrated Health Plan Developments

Revenue Management

  • Public Hospital Revenue Management Services

Third Party Billing Services

  • University Health Care
  • Newborn Screening


Value-Based Purchasing

Value Based Purchasing Design and Implementations Services

Transform your Medicaid program’s payment model – save costs while improving the quality of care and enhancing patient experience. PCG can help. Value Based Purchasing (VBP) is a payment strategy to measure, report, and reward excellence in health care delivery. Simply put, it is an effort to reward value over volume. 

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For physician group practices, PCG provides a wide range of accounting and financial management services under the Financial and Business Solutions Schedule (FABS):

Charge Capture Development

Evaluating existing charge capture tools for completeness and comprehensiveness.

Billing and Collection Services

Full outsourcing and come-behind billing and collection services.

Coding and Documentation Improvement

Identifying potential coding errors that require training and education and/or opportunities for revenue improvement.

Compliance Reviews

Monitoring of operational risks related to billing, documentation, collection, and other compliance-related matters.

Financial Reporting

Obtaining relevant information and reports to help manage clinical and financial operations.

Rate Sensitivity Analysis

Managing your rate structure to ensure optimal results from your charges.

Revenue Cycle Review

Ensuring all procedures performed are captured and enter the revenue cycle.

Reimbursement Negotiations

Assistance with development and negotiations of reimbursement rates from federal and commercial payers.