About Prospective Payment Specialists, Inc.

Prospective Payment Specialists, Inc. (PPS) is a compliance-oriented Independent Review Organization founded sixteen (16) years ago. Our principal offices are in Los Angeles, California.

Chargemaster review, maintenance and compliance for hospitals, multi-entity health systems and clinics have always been a primary business for PPS.

In the last sixteen years, PPS has provided its Chargemaster validation and maintenance services nationwide to over 1,600 hospitals and has performed over 3,300 comprehensive Chargemaster reviews.

PPS is also a preferred Chargemaster vendor for some of the largest hospital systems in the country. Chargemaster services including comprehensive validation, ongoing maintenance and standardization services comprise approximately 61% of our business while audit services, coding, and education services comprise the other 39%.

What We Do

A unique benefit to our approach is that our Chargemaster analysts specialize exclusively in Chargemaster services. Those who provide our Chargemaster services have a rare combination of clinical, coding, and financial expertise. In the niche created by the Prospective Payment System, it is imperative that a Chargemaster consultant understands both compliance and financial ramifications from a medically clinical, coding, and reimbursement standpoint. Therefore, each Chargemaster analyst is an expert coder, has taught Chargemaster and coding education classes and has a focused clinical background (RN, MT or ARRT) as well as having consummate knowledge of reimbursement and compliance issues in the technical and professional component. Further, we have very low employee turnover, with the most junior member of our Chargemaster staff being with us for over five years. This ensures that our clients are able to continue dialogue and ask questions of the consultants assigned to their project for as long as is necessary.