Case Study: Expanding Practice Uses Navicure To Strengthen Revenue Cycle

In 2002 , North Atlanta Primary Care (NAPC), an Alpharetta, Georgia-based practice, decided to make the transition from paper-based claims submission to an electronic clearinghouse solution. But instead to realizing anticipated revenue cycle enhancements, the practice found itself struggling to track claims and generate crucial reports. NAPC averaged a 50- day turnaround for claims reimbursement, and accounts receivable (AR) over 90 days stood at about 29% .Net collections hovered around 78%, with "no claim on file "as a frequent response when payers were contacted regarding claims status.

Efforts to contact the clearinghouse posed yet another problem. Stifled productivity resulted from staff commonly spending as many as 45 minutes playing "telephone tag" before actually speaking with a representative. "With 1^1/2 FTEs in the billing Department at time, our volume even then did not lend itself to saying on hold,"notes Melanie Wilkin, Insurance manager at NAPC.

After two years with a traditional clearinghouse solution, NAPC decided change was esstional for achieving future growth. The expanding particle needed a clearinghouse partner that would aid efforts to manage rejections, lower administrative cost accelerate payments and improve cash flow.