Hospital Billing Services

Institutional billing operates in a fundamentally different universe than professional physician billing. We bridge the structural complexities of UB-04 and 837I claims, dual prospective payment systems, and comprehensive chargemaster oversight to protect earned facility revenue.

How PNW Integrates Seamlessly with Your Clinic

Switching or upgrading your medical billing partner should never create downtime. Our transition process is designed for speed, security, and immediate claim acceleration.

1. Secure Role-Based Connection

We establish encrypted, HIPAA-compliant user logins directly within your current EHR and clearinghouse portal within 7 business days.

2. Coding & Charge Customization

Our certified coders calibrate your specialty fee schedules, customary modifiers, and clinical documentation guidelines to eliminate claim gaps.

3. Daily Execution & Monthly Reporting

Daily charge entry, immediate payment reconciliation, and transparent monthly executive reporting tracking your collection performance.

Facility Overhead

Capturing the equipment, pharmaceuticals, nursing care, and physical plant resources of the healthcare facility.

Revenue Codes

Proper pairing of 4-digit revenue codes with CPT/HCPCS lines ensures claims successfully clear clearinghouse edits.

Dual Payment Engines

Mastering IPPS DRG lump-sums and OPPS APC itemized line payments across Medicare and commercial plans.

Audit Defense

Protecting short inpatient stays against RAC and commercial takebacks using documented medical necessity.