Differentiators

FLEXIBLE REIMBURSEMENT MODEL 

• To align incentives with our client partners, PMA offers a Contingency pricing model wherein we appeal all available levels, and we are not compensated unless the denial is overturned.
• In the Contingency pricing model we cap our fees to support a favorable ROI for our clients
• PMA also offers a Fee-for-Service pricing model that bundles the first and second level appeals into a single cost.
• Regardless of the model, all denials are internally managed.

FLEXIBLE BUSINESS MODEL

We customize our services to meet the clients’ need:

• Clients can access the PMA portal at any time to check the status of an appeal.
• PMA does not submit generic letters of appeal. Our clinical nursing staff formulate all appeal letters specific to the denial and based upon a thorough review of the medical records. 
• PMA handles all denials internally; no work is outsourced to third parties.
• Some competitors only appeal inpatient level of care. PMA has expertise in appealing any status, including inpatient, outpatient, observation and so forth.

ACCESSIBILITY

• PMA is a local Houston business.  Thus, PMA is available to attend clients’ monthly Denial Management meetings or ad hoc meetings as necessary.
• PMA’s clinical team consists of a board-certified physician, certified nurse case managers, on staff attorney, and certified coding specialists.    

PMA is a Women Business Enterprise.