Our History


Provider Reimbursement Consultants, Inc. was established in 1979.  With such longevity in the industry, we have extensive experience assisting Clients through the constantly changing rules and regulations in the Healthcare industry. 


In 1984, with the implementation of the Inpatient Prospective Payment System (IPPS), our focus began to transition to ICD-9
coding and DRG assignments. We developed the services necessary to assist our Clients in reaching and maintaining
accuracy, optimum reimbursement, and compliance.


In 1990, we further broadened our reviews to include Outpatient CPT/HCPCS coded encounters, and Charge Masters. In 2000, with the implementation of the Outpatient Prospective Payment System (OPPS), our staff was well prepared, and our consulting services had already been updated to include the APC payment methodologies.

Subsequently, in 2007 we added MS-DRGs to our scope of services as it was adopted into Medicare’s Inpatient Prospective
Payment System. PRC’s staff assisted facilities with preparing and understanding the new DRG system to include a major emphasis on Clinical Documentation Improvement (CDI). With the implementation of ICD-10-CM/PCS in 2015, our staff was well trained in providing our Clients with education, and the highest quality of coding and documentation review expertise available.

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Our Staff


PRC’s staff is comprised of 100% full-time employees meaning everyone is fully committed to our clients’ success.  100% of our consulting staff is credentialed through American Health Information Management Association (AHIMA) and/or the American Association of Professional Coders (AAPC), and each member of our consulting staff is also a certified ICD-10 Approved Trainer credentialed by AHIMA.   Additionally, our firm has been pre-approved by AHIMA and the AAPC to award Continuing Education Units (CEUs) to attendees of our Educational Sessions.  PRC's consulting staff specialize in conducting Educational Sessions and presenting recommendations to your staff.

Approach


We approach each project with the individual client's objectives as our main focus. We closely work with you to arrive at a definition of success. We remain your greatest advocate, while you remain in charge.

PRC Helps You Navigate the Constantly Changing Rules and Regulations in the Healthcare Industry

Philosophy


Our success is inextricably tied to your own. If you can look back and see real, measurable progress, we’ve succeeded. Our team isn’t satisfied with their work until it produces tangibles that remain meaningful to you.

​Teamwork​


The PRC team is comprised of experienced professionals with extensive backgrounds in Coding, Compliance and Reimbursement. We rely on each other for varied skill sets in order to provide each client with the biggest benefit.

Our Mission

Our Firm was established in 1979, for the expressed purpose of providing the highest quality of consulting, coding, compliance, and reimbursement services available, exclusively to healthcare providers. We at PRC, have sustained our mission through the years, by maintaining a professional staff who is fully credentialed, experienced, and trained, and who place our clients’ objectives as their highest priority.