Membership and Billing
PGBA offers a comprehensive solution that features state-of-the-art enrollment and billing at the member, subscriber and group level. Our enrollment system provides online, real-time updates with the ability to track different benefits and coverage options.
We maintain provider data in our own provider information management system (PIMS). PIMS integrates with our claims processing system to ensure only active providers licensed and credentialed in their line of specialty receive payment for services rendered. The system also allows us to load negotiated fee schedules for procedure codes providers agree to through contractual agreements with participating health plans.