PMCS for Health Plans

Redefining claim reimbursement

A single source solution that advance funds out-of-network claim settlements to Providers, PMCS Advance ensures Payers receive the best possible discounts.

PMCS has built one of the industry’s largest Payer networks and has a strong base of pre-negotiated contracts. Through this exclusive network we’re able to offer exceptional discounts settled in record time. From post-adjudication to Provider payment, PMCS Advance’s use of electronic data interchange (EDI) delivers seamless administration, advance funding, and professional Provider negotiation.

  • Simplifies & reduces administration
  • Maximizes discounting capabilities
  • Provides prompt, predictable payment
  • Eliminates settlement disputes
  • Requires no change in funding cycles

PMCS Select is a fully automated out-of-network claim settlement solution that allows select Payers to remit payment and an Explanation of Benefits (EOB) directly to PMCS Providers.

  • Supplements current strategy
  • Automates payment & EOB
  • Leverages existing agreements
  • Eliminates Provider recourse

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