About Us

Your patients count on you to help them when they need it most. When you partner with PFA, you can count on us to help you balance your financial obligations while delivering quality healthcare.

At PFA, we have over 20 years of cost avoidance, revenue maximization and IT experience. Our business solutions focus on revenue enhancement practices that have generated millions of dollars in additional revenue for hospitals. As your business partner, we provide you the latest techniques in identifying, tracking, and improving your uninsured/underinsured reimbursement.

The challenges facing the health care industry in the coming years will affect your bottom line. The financial choices you make today will preserve the mission of tomorrow. PFA can turn around your reimbursement challenges and make them into profitable opportunities.

Products

Predictive Modeling

Our proprietary web based solution utilizes algorithms and predictive models to identify patient populations that are eligible for various public and private health insurance assistance programs. By capturing these populations at the front end of the revenue cycle, we are able to maximize claim reimbursements by effectively managing high utilizers and costly patients.

Health Insurance

Our expertise in identifying and working with public and private health insurance assistance programs ensures that your patient receives optimal services and expanded provider networks. Health insurance assistance programs can be Medicaid, employer sponsored insurance, health insurance exchanges and private foundations.

Provider Community

Our solutions increase provider revenue by reducing the underpayment patient population for providers including Hospitals, Specialty Care Clinics and Primary Care. Some of the benefits include higher patient satisfaction scores and provider loyalty.

Patient Advocacy

The Patient Helper Program ™ is a high touch patient and family centric approach we use to guarantee that your high cost patient population is receiving the most comprehensive health insurance assistance available. As the patient’s authorized representative, we minimize the efforts and complexity of health insurance assistance eligibility, enrollment and maintenance.

Our Team

James Fox BS- is an healthcare industry IT expert. James performed analytical research for various Massachusetts premium assistance programs and responsible for coding the States employer database which comprised of tracking employer sponsored health insurance offered in the Commonwealth of Massachusetts. James developed HIPAA compliant FTP cloud based solutions, created a user friendly database indexing detailed information on $450 million in Medicaid and Medicare billing errors and developed security protocol for clients which eliminated physical data leaks.
BS, MHA,CRCR- has 19 years of healthcare related experience working in provider and government settings. Jennifer spent 11 years overseeing operational programs on behalf of Massachusetts State Agencies. During 2005-2013, she expanded the Massachusetts Enhanced Coordination of Benefits (ECOB) program from 6 tertiary care hospitals to a total of 14. The program generated a combined total of MassHealth savings in the amount of $380 million with an estimated $114 million in additional revenue for Massachusetts hospitals.Jennifer is an active member of the Health Care Financial Management Association (HFMA). She Co-Chairs the MA/RI Revenue Cycle Conference and Co-Chairs the Revenue Cycle track of the HFMA Re.
Jack is a 25 year health care executive having held leadership positions at Massachusetts Medicaid, the Boston Medical Center and a publicly traded, Fortune 500 insurance company. Jack’s experience in the public sector, within a major teaching hospital and working for a private payer gives him unique insight into how to align incentives for patients, providers and payers leading to a more efficient health care system that delivers superior outcomes to patients.
Sumeesh is a highly skilled programmer using his degree in computer science in conjunction with several other engineering skills. He excels with software development and implementing the latest database technology in complex applications needing to handle large amounts of data. Mobile development and custom API integration are a few of the other talents Sumeesh implements at PFA. His exposer to healthcare IT over the recent years has led him to create some truly clever insights into the field regarding Patient management systems. He is currently the lead engineer for PFA’s patient management team overseeing other engineers and supporting employees.

Contact Us

Contact Us


Address

599 North Ave door 6 second floor wakefield MA01880

+1 (866) 591-8864

info@insidepfa.com

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