Pyramids Global -
Frequently Asked Questions
About Medical Billing & RCM

Yes, Pyramids Global provides fully customized RCM solutions for every client. If your practice has specific requirements related to billing software integration, credentialing, prior authorizations, patient inquiry handling, or any other billing need, our team will build a tailored solution that fits your practice perfectly.

Pyramids Global does not maintain proprietary billing software. Instead, we work with all major third-party billing platforms – including AdvancedMD, Kareo, eClinicalWorks, athenahealth, and more, ensuring your practice can continue using the software you are most comfortable with.

Yes, Pyramids Global works with a comprehensive list of third-party billing software platforms. We will help you select and implement the billing software that best fits your practice’s workflow, size, and specialty, at no additional complexity to your team.

Pyramids Global is fully responsible for all patient billing communication. Whether a patient has questions about their statement, a balance dispute, or an insurance explanation, our patient help desk team handles every inquiry professionally and accurately on your behalf.

When you partner with Pyramids Global, we assign you a dedicated account manager, team lead, and billing team. You will receive daily, weekly, and monthly financial statements covering your practice’s collections, claim status, denial trends, A/R aging, and overall revenue cycle health.

Pyramids Global believes in complete transparency. You will have full access to the billing system at all times, allowing you to review claim status, payment postings, denial reports, and all billing activity whenever you need it

Pyramids Global manages the complete insurance refund process on your behalf. We contact the insurance provider directly to verify whether the reimbursement request is legitimate. If valid, we balance the payment against future reimbursements and notify your practice immediately. If the insurer refuses the adjustment, we inform your practice so a direct refund can be issued to the patient.

Pyramids Global has designed a simple, low-cost medical billing solution starting at just $3 per claim, with no setup fees. To get started, contact our billing team at consult@pyramidsglobal.com or call (888) 511-5441. We will walk you through the onboarding process and have your practice billing efficiently within days.

Pyramids Global offers prior authorization services across 20+ medical specialties, including Electrophysiology, Cardiovascular Disease, General Surgery, Psychiatry, Pediatrics, Podiatry, Internal Medicine, Gastroenterology, Dermatology, Family Practice, Mental Health, Counseling, Ophthalmology, Chiropractic, Oncology Radiology, Rheumatology, Urgent Care, Speech Therapy, Physical Therapy, and Occupational Therapy.

Yes, Pyramids Global proactively monitors all active authorizations and notifies your practice well before expiration. We also initiate renewal requests in advance, ensuring your patients never experience a gap in authorized services that could result in claim denials.

Prior authorization processing times vary by payer and specialty. On average, Pyramids Global obtains most authorizations within 7 to 14 business days. For urgent cases, we escalate directly with the insurance carrier to expedite the process and minimize delays to your patients’ scheduled procedures.

When a prior authorization is denied, Pyramids Global immediately reviews the denial reason and prepares a detailed appeal on your behalf. We work with your clinical team to gather the necessary medical documentation and certify that the requested service is medically appropriate and required – maximizing the likelihood of a successful overturn.

Yes, Pyramids Global communicates directly with Primary Care Physicians for all referral inquiries on behalf of your practice. We submit referral requests via phone and fax, and our team follows up persistently until every referral is fully processed and confirmed.

Pyramids Global requests complete patient eligibility and benefits information from the scheduler at least two days before each appointment. We verify active coverage, co-pays, deductibles, and specialty-specific benefits, then send a full benefits summary to your practice via email and upload the notes directly into your EMR system for easy access.

Pyramids Global accommodates same-day and next-day patient additions. As soon as new patients are added to your scheduler, our eligibility team processes their verification as quickly as possible, ensuring your practice always has accurate coverage information before the appointment.

We will inform the practice about these concerns so they can get in touch with the specific patient and make the appropriate adjustments.

Yes, we go through each medical record pertaining to the services rendered and assign the correct code to process the claim.

Yes, specific CPT/ICD codes are used to code the claims. Our team then examines the codes and, as appropriate, provides input and review coding compliance and highlights if any areas need to be addressed. We also include the proper modifiers in the claims to ensure compliance and maximize your reimbursement.

Yes, we do review any denials, make necessary adjustments, and resubmit the claims with proper CPT, ICD, and Modifier.

We usually code the claims within 24 hours of the practitioner signing the medical records.

Yes, we will handle both your paper and electronic claim submission to the clearinghouse along with the denials management.

Yes, at your request, the system where you may view your claims and payments will be fully accessible to your team.

A professional account manager will be assigned to you and will be reachable by phone and email.

Yes, you will receive emails every day assessments of billing and collections.

Daily work is done on the clearing house, payer rejections, and denials, and a weekly summarized report is presented with the practice.

Monthly Financials, Missing claim tracking, Monthly Aging Numbers, Missing information reports, Any other billing report on Demand.

Yes, patients receive statements on a regular basis. The billing cycle can be modified to fit the needs of your practice.

We have experienced customer service specialists that will help the patients with their inquiries regarding invoices and payments.

Yes, we review your patient’s statements, the DOS of the procedures rendered, and the outstanding payment pertaining to the patient’s or the payer’s side.

No, we cannot update COB with payers as this can only be initiated by the patients.

Before calling patients with a reminder, we ensure the number of billing statements through mail via clearinghouse with a billing cycle of 28 days are sent as per practice policy. If they don’t reply to the statements, we then call or leave voicemails to remind them to make the payments. Lastly, we compile their statements and give them to providers, who then hand them over to recovery agencies.

Yes, your patients can call us from 08 am to 05 pm your time zone; their calls will route to our head office where one of our patient help desk specialists will assist.

Medical credentialing is verifying and documenting a physician’s qualifications and credentials and ensuring that the information available is accurate and complete within the insurance systems. We will help you contract with top payers in the industry to participate in their health plans.

We will ensure you will get enrolled with maximum insurance companies within the state as well as setting up EFTs and EDI.

Credentialing usually gets 3 to 6 months purely depending on the availability of insurance panel

It is the procedure through which a health insurer evaluates the credentials and abilities of a care provider using the given paperwork and the CAQH profile.

Yes, you can add new physicians to an existing group. All you have to do is provide us with the new list, and we will send it to the insurance company on your behalf.