CLIENT SPOTLIGHT: CARDIOLOGY OF TULSA

Nancy Nelson
Chief Administrative Officer
Cardiology of Tulsa
Practice specialty: Cardiology
Practice size: 25 providers (15 physicians, 10 mid-levels)

Cardiology of Tulsa (OK) is a full-service cardiology practice that offers comprehensive non-invasive diagnostic and therapeutic care ranging from disease prevention and testing to interventional cardiology and electrophysiology. Established in 1969, the practice has three offices in two cities, serving patients throughout northeastern Oklahoma.

When did you begin using Navicure?

Spring 2005

What claims processing technology had you been using prior to Navicure?

We used a large national clearinghouse, but had become increasingly disillusioned over time. The vendor’s scope of service was quite narrow and we felt we were not getting high quality customer support. We were experiencing a significant level of rejected claims due to front-end errors, and the clearinghouse was not following up to get those paid.

When you began searching for a new RCM vendor, what specific features were you looking for?

On the most basic level, we wanted to be sure we worked with a vendor that would submit clean claims because that would mean we would get paid more quickly. Also, we wanted functionality that would help us analyze why claims were getting denied so we could change internal processes that were letting errors get through. We also looked for electronic remittance functionality, and a solution that would help us with electronic secondary claims submission.

Why did you select Navicure?

Navicure offered all the functionality we wanted in one place – we didn’t have to go to different vendors to get different services.

We were also impressed with Navicure’s approach to denial management. The system is set up to catch any problems – both administrative, front-end errors and coding compliance errors – before the claim is even sent to the insurer. That allows us to correct them before submission, and eliminates the delay that comes with rejections and denials.

If a claim is denied, we are able to access relevant information online, which means we can immediately go back and gather additional information to resubmit the claim when appropriate. In the past, it would often take four-to-six weeks to accomplish this. Now we can turn it around in a day or two. That means we get paid a lot more quickly.

Navicure’s commitment to customer support was also a selling point. The company promises that support staff will answer the phone by the third ring – and that actually happens. If we have a question or run into a problem, we can simply pick up the phone and we are talking to a real person, not a recording, almost immediately. A lot of companies make customer service part of their sales pitch, but it isn’t genuine. That’s not the case with Navicure.

What other benefits have you realized as a result of implementing Navicure?

We’re able to submit secondary claims more quickly. Navicure offers electronic remittance advance and EOBs, which allows us to go online and pull together the information we need to submit to secondary insurers. Plus, Navicure provides the functionality to do this electronically – which Medicare now requires and which we expect to become standard for private payers in the near future, as well.

Plus, the solution gives us the ability to produce routine and specialized reports as needed. There is a great deal of functionality, in terms of reports – we can analyze the percentage of claims submitted by provider, for instance, or monitor claims status to see if we can identify trends and correct internal problems that contribute to denials.

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