CLIENT SPOTLIGHT: NORTH FULTON FAMILY MEDICINE (NFFM)

Melanie Wilkin
Administrative Assistant
North Fulton Family Medicine (NFFM)
Alpharetta, Georgia
Primary care; family medicine
19 providers — 10 physicians, 9 PAs

Established in 1998, NFFM is a full-service family medicine practice that utilizes state-of-the-art medical and computer equipment to provide patients with the highest level of care. NFFM providers see patients out of four offices on the north side of Atlanta in Alpharetta, Cumming, Woodstock and Johns Creek.

Began using Navicure's RCM: April 1, 2004

What claims processing technology had you been using prior to adopting Navicure’s RCM?

To say the clearinghouse we used before was “not great” is putting it mildly. There were a lot of problems. In fact, a huge percentage of our claims never even made it to the payer. We estimate that we lost more than 40 percent of our potential revenue every month because of these problems. We would be missing payments and, when we called the carrier, they would have no record that the claim was ever submitted.

Shortcomings were evident in other areas, as well. We were not able to connect with the clearinghouse to check on claims status or correct a claim if necessary. And, if we needed a report of some sort, we would have to contact them for the information – they never responded in a timely fashion, and what they provided us was generally unreadable. When we placed calls to their customer services department, we often were put on hold for 90 minutes or more.

We came to dread any interaction we had with them.

How did you go about searching for a new partner?

We knew we had to make a change and, about that time, we received a mailing from Navicure. Our CFO conducted quite a lot of research, and evaluated a number of systems. Navicure was simply better than the others and offered the capability of integrating with our practice management system seamlessly. When we were first introduced to Navicure, we simply said, “Wow!” It offered features we had never even thought to wish for.

Navicure was very easy to implement, too. At the time, our billing staff consisted of two FTEs and one part-time employee. We received one-hour of online training and were ready to go. It’s a fool-proof system and our staff picked it up very quickly, simply by following along with the training.

What benefits have you realized since implementing Navicure?

We really value the online access we have with Navicure. If we send out a claim and there is a problem, we receive feedback immediately. We can make a correction and resubmit it the next day. For instance, if the front office transposed digits in a patient ID, we don’t have to wait for a denial. We can go to the Navicure portal and correct the claim.

The reports are fantastic, too. We can check to make sure our claims have arrived at the payer, for example. If they don’t show receipt of a specific claim, we can make sure they get the information right away. This has virtually eliminated denials on claims due to the fact they didn’t meet timeliness requirements.

The edits engine is also very beneficial. Medicare’s CCI edits are built into the software, for instance, as well as notification when we need to use a modifier. If we have sent in a claim for a physical that included a chest X-ray and EKG, Navicure will let us know that we neglected to append the GA modifier. Navicure also offers payer-specific edits. There is no way our front-office staff, which enters codes and charges, can keep up with each payer.

Our cash flow has increased tremendously and we are recapturing the revenue we were previously losing. Our days in A/R have dropped from the high 40s to the mid-20s.

Navicure also has provided outstanding client support. When we call, the phone never rings more than once or twice. The staff is very knowledge and usually can answer any question right away. If they need to do some research, they get right back to you, often within 30 minutes.

How do you plan to expand your use of Navicure?

We’re looking at utilizing Navicure’s secondary billing and electronic remittance advice (ERA) features in 2007. We believe these services will enhance our revenue cycle even more.

We are growing rapidly, and just opened our fourth office. Our billing staff is now up to four staff members, but they don’t have to devote much of their time to claims processing. We use them to work with patients to arrange payment for outstanding balances, which is making our bottom line even healthier.

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