A mid-sized behavioral health provider came to Novigo for assistance because their back-office functions were not running as smoothly as they would like. With over 60 providers comprised of physicians, nurse practitioners, psychologists and with a volume of over 500 visits per day and approximately $14 million per year in gross revenue, the business needed an in-house billing staff and was still behind an average of 9 days on posting charges and payments. Claims follow-ups had fallen to 65-75 days after submission and the data entry and coding errors were growing. Pre-authorizations and pre-certifications were often missed, and a side effect of the slow billing was that balances were transferred to patients without follow-up to the insurance companies – resulting in patients receiving bills, which caused a great deal of frustration and phone calls. The problems were not only on the billing side, however; as no-shows and cancellations with less than 24 hours notice were through the roof.

Novigo’s dedicated client team was able to step in and help overhaul the practice’s existing system and replace it with Novigo’s system – while still maintaining and tracking aged claims on the existing system. With training on the new system at multiple locations handled by Novigo, they were able to bring on board updated scheduling, ledger systems and more with no appreciable downtime.

Keeping things organized with a multi-site practice can be challenging, so the front desk now has access to a daily schedule which is printed and distributed to providers for billing mark-ups – which are all scanned back to Novigo on the same day. With the integrated scheduling system, Novigo is able to ensure that all patient visits are pre-authorized, which helped patients visit the practice free of worry about denials and appeals.

Charging also received an overhaul, with audits and electronic filing to the insurance companies helping to get reimbursement in house much more promptly, while reducing the follow-up time for A/R claims. With Novigo acting as an insurance go-between, the practice was able to identify contracting and coding issues with IOP – resulting in an increase in IOP payments from an average of $112 to $168. Finally, Novigo helped implement a $50 no-show/cancellation policy to be signed by each patient; an action that has significantly reduced the no-show/cancellation rate.

When an Urgent Care center who provides occupational services, worker’s compensation and primary medical services contacted us about some billing challenges they were having with their current outsourced billing agency, we were happy to jump in and help. The center provides onsite X-rays, laboratory, splinting and casting, physicals for DOT, immigration and sports, as well as travel meds and laceration repair with upwards of 100 visits per day. They were using EMR and a practice management system, but it wasn’t providing them the support that they needed. The billing office the practice utilized wasn’t familiar with the needs of an Urgent Care location, and was building up an ongoing backlog of billing so the charges were not being submitted in a timely fashion. In addition, some of the applicable codes were not billed based on Urgent Care billing guidelines due to lack of industry-specific expertise which ultimately translated to lower overall reimbursements. A/R was as far out as 80 days, and the percentage of billing going to collection was high – meaning reduced revenue for the location.

Novigo’s client management team was able to quickly and efficiently review all existing protocols and contracts, ensuring that they were properly set up for charge entry and to capture the accurate billing codes to insurance. A dedicated audit team was launched to review each medical record to check the accuracy of the coding, and ensure that all applicable codes were billed. Any charts that were not completed by the physicians were escalated back for completion, and this along with the other steps helped reduce the overall days that A/R was outstanding. Any insurance agencies that had not yet contracted were contacted so the practice could be placed under contract for billing, while existing contracts were re-negotiated to ensure that the contract rates were the best available. This all resulted in a significant increase in the collection percentage, meaning higher overall revenue for the practice.

Our physical security is incredibly tight. We have a fully manned guard station and main desk, where visitors must sign in before they access the premises. All employees are given name badges with their picture on the front, and specific floors of the building. Inside the office, all portable storage devices have been disabled, such as USB drives and CD drives. Internet access is strictly controlled, and all external digital access is via a controlled VPN access point. We take the security of our clients’ records very seriously at Novigo.

The key benefits to your organization include improved cash flow, faster turnaround times for data processing (generally 24-48 hours), consistent and reliable follow-up on claims and accounts receivable, and a dedicated team that is able to support your business in a way that can be quickly scaled up or down depending on demand. Hiring new staff and getting them trained takes time, and if your business hits a slump you might feel pressured to lay off direct office staff members, or if your business all of a sudden starts to grow – you can really feel the pinch. When you use professional outsourced labor, these problems are easily solved!

In your office, it’s unlikely that you have the staff available to do a full quality assurance process on each patient record and file. However, our processes have been created with the quality control as a part of every record, so we are able to deliver a more consistent and comprehensive patient file, billing, and coding result every time.

Yes! Our Customer Service teams have been fully trained on patient needs, and that information will be combined with your specific requests as we speak with your patients. Rest assured that patients will receive the highest quality of care even after they have left your office.