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A message from Jim
Denny, Chief Executive Officer:
January 2006 marked the
fifth anniversary of Navicure. Over the course of the last five
years, our attention has been focused on building a first rate
clearinghouse with the best service in the industry to help
providers process their claims. The vision that inspired our efforts
during these years was largely drawn from years of watching
clearinghouses fail to serve the needs of the provider community.
As we turn our attention to the next five years, we plan to
continue expanding our offering to include a number of new products
and services that will enhance and simplify the collection of
payments. If the first five years were about improving claims
processing, then the next five years will be about improving and
simplifying claims payment.
With the launch of this
newsletter we hope to establish a forum in which to share
information about our new products, industry developments, helpful
insights from our clients and client service professionals, and our
company.
Thank you for your business and for your continued
support.
| Remits are on the Rise
 You may have seen the
announcement on our Web site, but just in case you missed it.
If you are sending claims to Medicare, Blue Cross/Blue
Shield or many leading commercial payers, you can say goodbye
to yet another paper pain in the neck by downloading
electronic remittance advice (ERA) data from Navicure's Web
site. We're adding new remits at a fast pace, making it easier
than ever that you take advantage of the increased efficiency
they provide.
Click below, or use the link on the
Navicure Web site, to see our current list of remit payers. If
you don't see the major payers you are using, check back
often, or drop us a quick message for the latest update.
So, what can you do with remit data? Well, depending
on your practice management system, you can download and post
it with a few mouse clicks. It makes paper explanation of
benefits (EOB) forms seem like slate tablets. But, there's
more.
ERA data is the key to Navicure's Dynamic EOB
manager. This tool helps you automate the process of preparing
paperwork for secondary claims. In fact, it makes it so easy;
you'll process secondary claims that may not have been worth
it before.
The EOB manager uses ERA data to create
"mock" EOBs. Using these, you can process secondary claims
without retrieving and copying the paper remittance advice,
manually highlighting the relevant patient data and crossing
out information unrelated to the secondary payer.
"The
new ERA/EOB capabilities have increased our productivity,"
said Andrea Mendoza from HeartPlace in Dallas. "The fact that
we now have ERAs available online with EOBs allowed us to turn
off paper EOBs with the payers. We started with Medicare and
Blue Cross/Blue Shield and we've added several other large
payers since then. It's a great time saver," said Andrea.
If you'd like to find out more, you can download a
flash demo of the Dynamic EOB Manager, or get a live demo.
Just drop us a note saying you're interested. You'll be glad
you did.
Click here to see our Remit Payer List
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| Meet Kristi Kenny -- Senior Client Service
Representative
 If you've been lucky enough
to work with Kristi Kenny, you know she is a physician EDI
expert and a "super power user" of Navicure. What you don't
know is that Kristi is a Kansas native who has traveled the
world as a member of "Up with People," lived in Ireland for a
couple of years, is married to an Irishman and once worked in
the film industry.
Kristi's Up with People tour lasted
a year and included performances in Ireland, England,
Switzerland, Austria, Italy, France, Germany, Canada and
throughout the Northeastern United States. After her world
travels, Kristi moved to Atlanta to work with a company that
provides equipment to movie producers who are shooting on
location. In Atlanta, she met her husband and fell in love
with the South.
Kristi's physician EDI career began
when she joined NDC (later called NDCHealth) in 1998. The NDC
physician EDI business later became MedUnite, then ProxyMed
and is now known as MedAvant. In 2001, Kristi and her husband
Sean moved to his native Ireland to assist with his family's
business. Upon returning from Ireland, she resumed her
physician EDI work with ProxyMed.
"Kristi joined
Navicure in 2003 and has made an important contribution to the
company's success and growth," said Laura Bridge, director of
client services. "Her deep understanding of physician EDI and
the Navicure application is only eclipsed by her helpful,
friendly nature and infectious laugh."
"I love
interacting with our clients and helping them with their
questions and concerns," Kristi says. "There's always a new
challenge, particularly when it comes to figuring out what the
payers want - which is not always what they say the want."
All we can say is we're glad Kristi is not in Kansas
anymore.
Navicure Web Site
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What is a
Payer ID?
Electronic claims use a unique code that
identifies that payer, just like the payer address is used for
paper claims. If you send a claim to Navicure that does not
include a payer ID, the claim will automatically drop to
paper. The electronic payer ID can be corrected on the
Navicure HCFA form by updating the payer drop down under
Insurance Mailing Address (Figure 1).
If your practice
has not contracted with Navicure for paper claim processing
the following rejection message will be displayed:
"PAPER CLAIMS NOT PURCHASED. PLEASE PRINT LOCALLY."
In this case, you may cancel the claim in Navicure and
print it on your office printer, or correct the payer drop
down and resubmit in Navicure (Figure 2).
What should
I do when a Provider ID rejects at Navicure?
Practice
provider numbers are set up in the Navicure system during the
enrollment process. The system retains these numbers so edits
can be performed to ensure bad data is not passed to the
payers. It is important to note that Navicure does not
manipulate submitted data. If any other provider number is
uploaded to Navicure, the claim(s) will reject and you will
see one or both of the following rejection messages:
"BILLING PROVIDER ID DOES NOT MATCH NAVICURE
ENROLLMENT."
"RENDERING PROVIDER ID DOES NOT MATCH
NAVICURE ENROLLMENT."
When these rejections notices
are received, you should confirm the provider number(s) being
sent from your practice management system, and then either
correct them online or contact Navicure to have the provider
number(s) updated by our enrollment specialists.
As a reminder...
The data listed on the
Navicure HCFA in Box 33 is what will be sent to the payer as
the provider number(s). (See Figure 3)
Contact
Navicure for more information. |
| Next Issue: Secondaries
You may be aware that Navicure recently introduced new
functionality to create and send Medicare secondary claims
electronically. We're also accepting secondary claims for Blue
Cross/Blue Shield of Texas and United Healthcare.
In
our next issue, we'll provide details on our current secondary
capabilities and give a look at what we have planned for the
near future. In the meantime, feel free to call or e-mail
Navicure with questions and/or download our Secondary COB User
Guide using the link below.
Secondary COB User Guide
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It's Your Turn...
We want to make this your newsletter as much as ours. There
are several ways you can get involved:
Send us a tip on how
to get the most out of Navicure. If we use it in NaviNews, we'll
send you a $100 Amex gift card.
Tell your colleagues about
Navicure. If they become a new client, we'll send you $100 for each
provider in their practice and, for five or more, we'll also cater a
special lunch for your entire office. Who says there's no free
lunch?
Finally, if you have suggestions for subjects you
would like to have us cover in NaviNews, or if you have questions,
please send an e-mail to Peter May at pmay@navicure.com.
We
hope you enjoy the newsletter. Thank you for your continued support.
Sincerely,
--The Team at Navicure
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