PMMC provides revenue cycle management tools to healthcare delivery systems, acute care hospitals, critical access hospitals, academic physician organizations and multi-specialty physician groups. Helping find additional cash and creating efficient workflow processes allows clients to improve margins and continue to effectively serve their community.

The Revenue Maturity Matrix is a proven, four-phased approach that enables healthcare providers to improve the bottom line and become more competitive in today's healthcare environment.

Contract Governance

A successful revenue cycle maturity strategy begins with contract governance, or contract management. This ensures that your hospital is being reimbursed accurately for all the services provided and identifies which claims are being underpaid or denied. Measuring payer performance and understanding how payers compare to one another is a critical component to contract governance.

Payer Negotiations and Strategic Pricing

After healthcare providers have established contract governance, this historical data can now be leveraged to aggressively model payer contracts in real-time while using the same platform to develop a competitive rate setting strategy and understanding the impact on their current contracts and net patient revenues.

Pricing Transparency

Healthcare providers can utilize the same platform that drives contract governance, modeling and rate setting to deploy a successful patient engagement strategy for pricing transparency and consumerism. In healthcare today, this means giving patients the means to price shop for healthcare services.

Value Based Reimbursement

Healthcare providers will be challenged in gaining a competitive advantage as the market shifts from fee-for-service to value-based reimbursement. PMMC enables healthcare providers to lead with a high value and high volume strategy by incorporating current contract governance and risk assessment.

PMMC provides revenue cycle management tools to healthcare delivery systems, acute care hospitals, critical access hospitals, academic physician organizations and multi-specialty physician groups. Helping find additional cash and creating efficient workflow processes allows clients to improve margins and continue to effectively serve their community.

The Revenue Maturity Matrix is a proven, four-phased approach that enables healthcare providers to improve the bottom line and become more competitive in today's healthcare environment.

Contract Governance

A successful revenue cycle maturity strategy begins with contract governance, or contract management. This ensures that your hospital is being reimbursed accurately for all the services provided and identifies which claims are being underpaid or denied. Measuring payer performance and understanding how payers compare to one another is a critical component to contract governance.

Payer Negotiations and Strategic Pricing

After healthcare providers have established contract governance, this historical data can now be leveraged to aggressively model payer contracts in real-time while using the same platform to develop a competitive rate setting strategy and understanding the impact on their current contracts and net patient revenues.

Pricing Transparency

Healthcare providers can utilize the same platform that drives contract governance, modeling and rate setting to deploy a successful patient engagement strategy for pricing transparency and consumerism. In healthcare today, this means giving patients the means to price shop for healthcare services.

Value Based Reimbursement

Healthcare providers will be challenged in gaining a competitive advantage as the market shifts from fee-for-service to value-based reimbursement. PMMC enables healthcare providers to lead with a high value and high volume strategy by incorporating current contract governance and risk assessment.

There is a different way to work. If you were to reimagine the way you run your business, what would you do differently? What if you could save up to 80% of your operational costs by reimagining the way business outcomes are delivered?

Through the power of automation emerging technologies, we challenge you to think differently about how you work and how you use your people to full effective.

We can help you across the automation journey from thinking through your strategy to implementing and executing robotic process automation, machine learning and other emerging technologies across the enterprise.  

Revenue Cycle Management:

Prior Authorization ​

Insurance Claims - Posting

Patient Payment - Posting

Coordination of Benefits: Primary, Secondary, & Tertiary

Revenue Integrity - Payment Audits (Under & Over)

Provider: Insurance Enrollment

Revenue Integrity - Charge Description Master (CDM) Management

Revenue Integrity - IME or IMR Audits (CMS & Medicare Advantage)

Insurance Claims - Denied & Rejected Follow-Up

TQA Healthcare enables healthcare and life sciences organizations to transform the patient experience and reduce costs through increased personalization, intelligent automation, and AI. 

The practice’s solutions impact patient access, the revenue cycle, order processing, and clinical needs at the most critical stages of the patient journey, resulting in a seamless encounter.

By empowering individuals to actively manage their unique experiences, TQA Healthcare increases the satisfaction of every healthcare consumer: patients, staff, and clinicians.

Houston-based, TQA Healthcare is formerly Element Blue. 

While EHRs offers integration tools, achieving seamless data exchange, particularly with non-EHR systems, can be challenging due to their limited interoperability.

This can create communication hurdles between providers using different EHRs, healthcare facilities not on a particular EHR, and providers who need to integrate with other advanced technology platforms outside of the EHR ecosystem.

Element Blue's solutions can integrate with any platform and are independent of particular products or technologies. This affords our teams unlimited creativity when ideating custom solutions for each healthcare organization.

Element Blue's practice is dedicated exclusively to healthcare and life sciences. This is unique among our UiPath competitors, who serve multiple industry verticals.

A UiPath Platinum partner, Element Blue is recognized as a leading systems integrator with more than 20 years' experience in working with some of the world's best known providers, payers, diagnostics, and life sciences organizations.