Client Overview
Nomi Health, a national leader in healthcare programs and payments, manages over $150 billion in healthcare expenditures and analyzes $500 million in employer healthcare claims annually. They aim to reduce operational healthcare costs by half, impacting over 12 million individuals. By integrating advanced technology, they enhance service delivery and healthcare accessibility.
The Challenge Unfolds: The Catalyst for Engagement
Violet's concerns were multifaceted, focusing on security, efficiency, communication, expertise, and adaptability:
Initial Engagement: Our relationship with Nomi Health began in February when they faced cash flow issues due to a backlog of COVID claims caused by a cyber-attack on their clearinghouse, disrupting 1 million claims.
Deepening the Crisis: The attack stalled millions of dollars in COVID claims reimbursements, straining the client’s ability to deliver essential services. The situation demanded an urgent and strategic response to manage the backlog and ensure operational continuity.
Strategic Response and Solution Implementation
Technological Intervention: To address the crisis, we implemented Office Ally, a versatile and reliable EHR + clearinghouse system, within seven business days, onboarded 90 staff, and started processing the 1 million COVID claims.
Rapid Implementation: Our swift deployment of Office Ally halted financial losses and restored operational stability, enabling the client to manage their COVID claims more securely and efficiently.
Expanding Our Role: Impressed by our crisis management, the client expanded our responsibilities to include complete billing operations management. This included a successful trial billing phase and additional staff onboarding to handle complex COVID claims billing tasks.
Comprehensive Execution and Impactful Results
Effective Management of 1 Million COVID Claims:
- Submitted 1 million disrupted COVID Claims, crucial for financial recovery and operational confidence.
- Focused on accuracy and completeness, ensuring minimal errors during the process.
Improvement in Claim Processing Accuracy:
- Reduced error rates from 15% to below 5% through rigorous quality checks.
- Lower error rates led to fewer rejections and faster payments, enhancing financial stability.
Improvement in Claim Processing Accuracy:
- Successfully managed high volumes of data under pressure, maintaining client financial integrity.
- Reinforced operational excellence and client satisfaction through our dedicated efforts.
Improvement in Claim Processing Accuracy:
- Successfully managed high volumes of data under pressure, maintaining client financial integrity.
- Reinforced operational excellence and client satisfaction through our dedicated efforts.
Sustaining Optimized Revenue Cycles
The resolution emphasized the need for continuous vigilance in revenue cycle management, strategic partnerships, and robust technology systems to maintain high service quality and financial performance amid unexpected challenges.
