BILLING MANAGER EDI SURVEY — NAVICURE

 
Here is the complete 2016 clearinghouse review for Navicure. CH.org does its own primary research and interviews the clearinghouses personally with standardized criteria important for billing managers to obtain accurate data. The information below is provided directly from Navicure to Clearinghouses.org and is reliable.
 
1. Call Wait Times. (how long do I have to wait to talk to support?)
 
Navicure’s devotion to our clients is unmatched. Our 3-Ring Policy™ ensures that all client phone calls are answered by our knowledgeable support staff within three rings or less. We guarantee it.
 
2. Payer List. (Do you have connectivity to the payers that I need to send claims to?)
 
Navicure has over 2000 payer connections and counting. If a payer accepts claims electronically, you can send claims to that payer.
 
3. PM Support. (Does your company integrate with my PM system? Is your support staff knowledgeable about my PM?)
 
Navicure is an integrated partner with the top PM/EHR companies in the industry. With over 35+ channel partnerships you can be assured that Navicure will have the ability to integrate with your PM/EHR for a seamless workflow. In addition, our PM specific enrollment, implementation, and integration specialists facilitate a trouble-free clearinghouse transition.
 
4. Missing Claims. (My payer does not show as having received my claims. I don’t want to wait 2-3 weeks to find this out. How do I tell in real time if I have missing claims?)
 
Navicure® ClaimFlow™ has robust claims tracking. Every claim is monitored through the reimbursement cycle with complete visibility to the user. Each data transmission is time and date stamped, and given a transaction ID. If the appropriate response from a payer isn’t received, Navicure will follow up with the payer on the client’s behalf.
 
5. Claim Scrubbing & Validation. (What are your rejection rates? To high = Too many payer denials. Too low = Too many EDI rejections).
 
Edits in Navicure® ClaimFlow™ are always up to date because we manage our system daily (versus quarterly or yearly). If our system sees a rejection it has never seen before, an alert is issued to Navicure’s payer operations department. We will contact the payer to determine if a new edit should be build.
 
6. RCM Dashboard — to detect slow payments, cash-flow issues, and excessive A/R days. Does your service help me manage unattended Claims, manage rejections and denials. Does it report errors as codes or as full explanations? Does your service report back to my PM with error messages, ERA’s, etc.?
 
Navicure ClaimFlow’s online dashboard is where the user can see the status of every claim at any point in the reimbursement cycle. Our solution enables users to manage their A/R by providing unparalleled transparency into their claims. The data is categorized (claims rejected, denied, processing with Navicure, and processing with the Payer) and concise with more detailed information available one click from the home screen. Our reports provide easy to understand reason codes so that practices can identify the root cause of the rejection or denial and prevent them in the future. The application also provides deep integration back into the PM systems to varying degrees depending upon the vendor.
 
7. Real Time RCM Reporting. (Do I have to wait until the end of the month to detect blocked cash-flow, lost or unattended claims?).
 
Navicure ClaimFlow’s editor scrubs claims instantly. Our clients rework rejected claims and resubmit them within a few minutes, ensuring real-time transparency.
 
8. Patient Payments. How does your service help me estimate payment responsibility to determine the patient portion upfront, so our front office can collect patient payments during the appointment?
 
With Navicure® Payments™, clients have the ability to estimate a patient’s cost of care at the time of service. Our solution leverages your practices’ historical remittance advice, taking into account Payer and CPT code, to produce the patient’s estimate.
 
9. Analytics. How does your service/technology give me insight into financial and operational performance across our organization?
 
Navicure® ClaimFlow™ was designed to provide unparalleled visibility into providers’ revenue cycles. In particular, the ClaimFlow Scoreboard pioneered transparency into the claims management process showing where claims are at every step so that providers can take action. With Navicure® Perform™, an action-oriented business intelligence solution on the verge of Beta release, users can not only identify issues but also drill down to correct them at the source.
 
10. Proactive Revenue Controls. How does your system proactively and continually monitor key performance indicators (KPIs) to enable us to act in real-time to address revenue leakage before it significantly impacts our cash-flow?
 
Navicure® Perform™ also provides user-configurable dashboards, which include KPI benchmarks from Navicure’s broad client base, helping users uncover areas for performance improvement.