As one of the premier outsourcing organizations for healthcare business practices, Novigo is dedicated to providing the very best quality, service and value for your organization. Here are just a few of the stories in the news that may be of interest to you.

We can spend a great deal of time detailing all of our different business offerings, providing you with the hard facts and data that you need to evaluate an organization. However, how can you bring to life the actual impact that our various services can have on organizations just like yours? We hope these case studies will help tell the story of how Novigo is making a sincere impact on healthcare organizations throughout the U.S. by painting a picture that will bring to life just a few of the ways that we can support your organizational goals as well.

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 followups 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 followup 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 multisite practice can be challenging, so the front desk now has access to a daily schedule which is printed and distributed to providers for billing markups 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 followup 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 renegotiated 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.