CATHRYN D. FOX
Senior Recovery Consultant

Mrs. Fox comes to pmpm® Consulting Group Inc. with nearly twenty years of experience in the business of medical accounting, claims recovery, auditing, and revenue management for HMO, IPA and PPO operations. Her special expertise lies in helping clients to update their recovery programs and pursue uncollected revenues. Through a comprehensive assessment process, she advises clients regarding the structure and systems changes necessary to optimize their revenue recovery. She develops policies and procedures specific to clients’ organizational needs and the terms of their managed
care contracts.

Mrs. Fox has developed a systematic centralized approach to ensure aggressive recovery efforts and ably trains client staff to manage this program. She also offers ongoing support wherein she performs all or portions of the recovery functions on behalf of clients off -site at offices. Before joining pmpm®, she managed the Customer Service and Eligibility and Recovery Departments of the Community Health Network of Stockton. There she was responsible for maintaining eligibility of IPA members, verifying capitation received from HMOs, and recovering revenues disbursed as duplicate payments to providers. She also pursued contracted agreements with the HMO for stop loss, enrollment protection, non-capitated services, eligibility guarantee, low enrollment and shared risk. She performed similar responsibilities in her previous appointments in management of the Eligibility and Recovery Department for an IPA, Napa Valley Physicians, and the Audit & Reconciliation Department of Managed Care Systems, Inc. in Sacramento. Mrs. Fox also brings experience with private medical practice, having managed both the front and back office functions including accounting and revenue management systems.