Guam’s medical billing partner, working your claims around the clock.
End-to-end billing, coding and collections for healthcare providers in Guam, Saipan and the US Mainland, handled by AHIMA / AAPC certified professionals who know the local payers.
- No monthly minimum
- No extra fees
- AHIMA / AAPCCertified billing and coding professionals
- HIPAACompliant systems, signed NDAs
- 24/7Billing support coverage
- 8+ yearsGuam and Saipan payer experience
- 13+ yearsIn business
Billing built around how island healthcare actually works.
Pacific Practice Solutions is a knowledge process outsourcing company built for the healthcare revenue cycle. We pair certified billers and coders with hands-on knowledge of Guam and Saipan payers and US mainland insurance, so your practice is paid accurately and on time.
Practices that outsource billing to PPS can cut billing costs by 50–60%, while our workflows are designed to bring in more revenue.
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We know the local payers personally
Years of direct experience with Calvo’s SelectCare, NetCare, Staywell, TakeCare and Guam and Saipan Medicaid. We know their documentation requirements, submission preferences and adjudication timelines, which mainland billing companies rarely do.
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Your claims are worked around the clock
Most billing companies stop when the mainland sleeps. We operate 24/7, so claims are submitted, followed up and appealed whatever the time zone.
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A dedicated account manager on island
Every client gets a Guam-based Client Service Manager who can resolve issues the same day and walk into your office when needed, plus a billing manager as your single point of contact. No call centers, no runaround.
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We train your front-office team too
Billing problems often start at registration. We provide hands-on training for scheduling, pre-registration and clinical staff so documentation and compliance are right from the first patient interaction.
End-to-end revenue cycle management.
From patient registration to final payment, we manage every step of your billing workflow.
Medical billing
A high first-pass claim acceptance ratio. We handle submission, follow-up and appeals so you get paid faster.
- Charge entry
- Electronic and paper claim submission
- Claim corrections
- Payment posting
- Patient statements and online payments
Accounts receivable management
Proactive follow-up on aging claims, so revenue doesn’t sit unworked.
- Insurance follow-up
- Aging AR review
- Outstanding claim research
- Patient balance follow-up
Denial management
We find out why claims are denied, fix them, and stop the same denials coming back.
- Denial analysis
- Corrections and resubmissions
- Appeals
- Root-cause reporting
Medical coding
AAPC and AHIMA certified coders for accurate code assignment, fewer denials and protected compliance.
- ICD-10-CM
- CPT / HCPCS
- Radiology coding
- Coding review
Credentialing and provider enrollment
From application to approval, including support for providers launching new practices in Guam.
- Guam insurers and US commercial payers
- Medicare and military payers
- Re-credentialing
- Enrollment follow-up
Eligibility and prior authorization
We verify coverage and secure authorizations before services are rendered, preventing denials at the source.
- Insurance eligibility checks
- Prior authorization requests
- Authorization tracking
Also available
- Patient scheduling
- Medical transcription
- Auditing
- Superbill preparation
- Scanning
- Practice management software
Every payer your practice works with, covered.
Our team has hands-on experience with claims, follow-up and billing workflows across island, federal and national payers.
Guam and Saipan
- TakeCare
- Calvo’s SelectCare
- Staywell Health Plans
- NetCare
- Guam Medicaid
- Saipan Medicaid
Federal and military
- Medicare Part A & B
- Medicare Advantage
- TRICARE
- TriWest
- VA
National commercial
- Aetna
- Cigna
- Blue Cross Blue Shield
- Anthem
- UnitedHealthcare
- Humana
Other plans
- Workers’ compensation
- Self-funded plans
- Third-party administrators
- Other commercial health plans
Some local insurers don’t accept electronic claims. We submit paper claims directly at their offices, so nothing gets stuck.
Ask about your payersHow we work with your practice.
A structured process that finds billing issues, sets clear accountability and gives you visibility from day one.
Assess
We review your billing workflow, payer mix, aging AR and day-to-day challenges.
Plan
We build a service plan around your specialty, EHR and staffing, with clear responsibilities on both sides.
Execute
We work claims, payments, denials, AR and every function we’ve agreed to handle.
Report
You receive KPI, aging, denial and productivity reports, plus custom reports whenever you ask.
Ready to see where your revenue cycle stands?
Start with a free assessmentYou’ll never have to guess where your money is.
Every number is accessible, every trend is explained and every dollar is accounted for.
Monthly A/R reports
Outstanding balances by payer, aging bucket and provider.
Denial statistics and trends
Denial patterns, root causes and resolution rates over time.
Claim submission tracking
Turnaround times and first-pass acceptance rates.
On-demand custom reports
Request any report you need, without waiting for the next billing cycle.
Sample data for illustration only. Your reports show your own balances by payer, aging bucket and provider.
Works with your specialty and your software.
We support physician and healthcare organizations with specialty-specific billing and coding, inside the systems you already use.
Specialties we support
- Primary care and internal medicine
- Radiology and interventional radiology
- OB/GYN
- Behavioral health
- Cardiology
- Pediatrics
- Orthopedics
- Other physician and specialty practices
EHR and practice management systems
- eClinicalWorks
- NextGen
- Allscripts
- Practice Fusion
- Cerner
- e-MDs
- GE Centricity
- NueMD
- CollaborateMD
- AdvancedMD
Using a different system? Tell us which one and we’ll confirm. We can also provide practice management software as part of our service.
Your patient data is protected at every step.
We follow HIPAA guidelines strictly and put the safeguards in writing.
- HIPAA compliance guidelines followed strictly
- HIPAA-compliant Amazon Web Services hosting
- Non-disclosure agreement signed with every client
- Non-disclosure bonds signed by every staff member
- Password-protected systems and email, with no local storage devices
- Premises monitored by surveillance cameras
Questions practices ask us first.
Don’t see yours? Call us and talk to a person.
Call (302) 304-8525Is there a monthly minimum or any extra fees?
No. There is no monthly minimum and no other extra fees.
Will outsourcing to PPS save us money?
Outsourcing can reduce billing costs by 50–60% compared with running billing in-house, and our workflows are designed to help you generate more revenue.
Do you handle credentialing with local insurers?
Yes. We provide credentialing for providers and practices launching in Guam, with both local and US mainland insurance companies.
Do you submit paper claims to local insurers?
Yes. For insurers that don’t accept online claims, we submit paper claims at their office.
Who will be working on my account?
Every client is assigned a billing manager as a single point of contact, backed by a Guam-based Client Service Manager. Our team members are certified billers and coders with at least 3 years of experience, and all hold a bachelor’s degree.
How is my data protected?
We follow HIPAA guidelines strictly, sign a non-disclosure agreement with every client and a non-disclosure bond with every staff member, and use HIPAA-compliant Amazon Web Services. Our systems and email are password-protected, we don’t use local storage devices, and our premises are monitored by surveillance cameras.
Can PPS support us over the long term?
Yes. PPS is free of debt and makes sure every contract and agreement is duly signed. We have offices on the US Mainland.
Let’s find the revenue your practice is leaving unpaid.
Tell us about your practice and your biggest billing challenge. A PPS representative will contact you to talk through what you need. The assessment is free.
What we can review with you
- Aging accounts receivable
- Denials and unpaid claims
- Claim submission workflow
- Payment posting and reconciliation
- Coding and billing workflow
- Staffing and outsourcing opportunities
- Prefer to talk?
- (302) 304-8525
- Hours
- Monday to Friday, 8am to 10pm
Request your free assessment
No monthly minimum. No extra fees.
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