Sector Focus: Health Systems & Hospital-Based Medical Groups

Extended Business Office (EBO) Surge & Time-Boxed A/R Cleanup

Rapid cash acceleration without permanent overhead. Nova Arc deploys specialized, certified revenue surge pods that seamlessly overlay your existing hospital business office to liquidate aged A/R backlogs, overturn complex clinical denials, and recover trapped revenue during EHR conversions, staffing vacancies, or M&A integrations—available on a 100% contingency, risk-free model.

Schedule EBO Backlog Evaluation View Staffing Overlay Diagram → Zero Upfront Cost • 100% Contingency Options
90–120 Days
Time-Boxed Cleanup SLA
Rapid milestone-driven liquidation window with zero long-term vendor lock-in
0 FTEs
Permanent Headcount Added
Turnkey co-sourcing overlay that leaves your existing staff fully focused on current billing
100% Contingency
Zero Upfront Financial Risk
Fees tied strictly to net cash recovered on aged claims nearing write-off
$1.8B+
Aged Backlog Cash Recovered
Proven performance across 340+ hospital networks and hospital-based specialty groups
Operational Crisis Scenarios • When to Deploy EBO

When Do Health Systems & Hospital-Based Groups Deploy EBO Surge Pods?

Even the strongest hospital revenue cycles encounter acute operational disruptions that overwhelm internal billing teams. Nova Arc's Extended Business Office is purpose-built to step in, absorb the shock, and restore balance sheet health.

EHR Go-Live / System Migration Freeze

Migrating to Epic Resolute, Cerner Millennium, or MEDITECH Expanse inevitably triggers a temporary 30-to-60 day cash freeze. Workqueue volumes quadruple, charge routers misfire, and billing clerks struggle with new software. Nova Arc overlays legacy queues, keeping cash flowing while your team masters the new system.

Aged A/R Past 90/120 Days Threatening Timely Filing

When aged receivables exceed 20% of your total ledger, internal staff are forced to triage—working fresh claims while older claims age toward commercial timely-filing limits (typically 90 to 180 days). Nova Arc's surge teams attack aged buckets with algorithmic speed before claims become uncollectible write-offs.

Acute Staffing Shortages & Billing Turnover

Healthcare billing turnover exceeds 25% annually. When senior appeal specialists or inpatient hospital billers resign, institutional knowledge is lost and backlogs instantly mushroom. Nova Arc provides immediate, credentialed surge pods within 5 business days, eliminating recruiting delays and training lag.

M&A Integrations & Acquired Group Ledgers

When a health system acquires community hospitals or hospital-based specialty groups (radiology, anesthesia, pathology), the legacy A/R is often trapped in disparate systems. Nova Arc runs a time-boxed wind-down of legacy practice management software, extracting maximum cash while the enterprise moves forward on Epic or Cerner.

The Non-Disruptive Co-Sourcing Model

The EBO Staffing Overlay Architecture

Nova Arc's staffing overlay is engineered to integrate alongside your existing hospital billing operations. We never displace or disrupt your internal team—we shield them from historical backlogs so they can focus on current day-to-day cash.

Bi-Directional Co-Sourcing Architecture

Dual-Layer Workqueue Partitioning & AI Sentinels

100% Native EHR Integration (Epic / Cerner / MEDITECH)
LAYER 01: INTERNAL CORE

Hospital Internal Billing & Patient Access Staff (0 – 60 Day Accounts)

100% Operational Protection

Your existing team remains completely focused on current business: front-end patient intake, daily appointment scheduling, initial clean-claim scrubbing, and routine billing inquiries. They are protected from aged workqueue distraction, preventing new backlog creation.

Fresh Charge Capture Primary 837 Dispatch 0-60d Insurance Remittances Routine Patient Inquiries
LAYER 02: NOVA ARC OVERLAY

Nova Arc Specialized EBO Surge Pods (60+, 90+, 120+, 180+ Day Accounts)

Dedicated Revenue Pods

Specialized surge pods deploy directly into your EHR (Epic Resolute WQ 102/104/108, Cerner Millennium, or MEDITECH B/AR). Each pod is tailored to your clinical setting (Inpatient Acute DRG, Outpatient Surgical, or Hospital-Based Radiology/Anesthesia/Pathology), liquidating aged claims nearing timely filing.

Pod A: Clinical Denial & RAC Appeals
Inpatient DRG acuity, medical necessity, peer-to-peers
Pod B: ProFee & Underpayments
Modifier 26 split-billing, anesthesia units, MPPR
Pod C: High-Dollar Commercial A/R
Timely filing appeals, stop-loss claims, payer escalations
Pod D: Credit Balance & CMS 60d
False credit elimination, 838 reporting, audit packages
LAYER 03: AUTONOMOUS SENTINEL

Automated EDI 276/277 Statusing & Root-Cause Feedback Loop

Closed-Loop Feedback

Our automated clearinghouse sentinels execute thousands of electronic claim status inquiries daily, eliminating telephone hold times. Concurrently, every root-cause insight discovered in aged accounts is fed directly back to your internal team via weekly dashboards—permanently curing the front-end intake and coding defects that caused the backlog in the first place.

Milestone Governance • 90 to 120 Day Turnaround

The Time-Boxed Cleanup Engagement Model

Hospital leaders avoid consulting engagements that drag on indefinitely. Nova Arc's EBO projects operate under strict, time-boxed charters. We ingest the aged backlog, liquidate the claims, train your internal team on preventative rules, and cleanly exit.

01
Days 1 – 14

Rapid Ingestion & Portfolio Scoring

Securely connect into your EHR. Our algorithmic models stratify your aged accounts by collectibility, recovery yield, and timely-filing risk. High-dollar surgical and inpatient claims nearing timely-filing deadlines are tagged for immediate Day 15 attack.

Deliverable: Stratified Portfolio Matrix & Worklist Lock
02
Days 15 – 45

High-Velocity Mass Liquidation

Surge pods execute systematic payer follow-ups, submit automated 276/277 status inquiries, re-transmit scrubbed electronic 837 claims, and dispatch first-level clinical appeal packages. Initial cash acceleration surge hits hospital bank lockboxes.

Deliverable: 45% – 55% of Backlog Resolved or Paid
03
Days 46 – 75

Complex Appeals & Contract Discrepancies

Focus shifts to contested accounts: high-level administrative appeals, Medicare RAC dispute packages, commercial contract underpayment demands, and credit balance reconciliation. Payer escalations are managed at the provider relations executive level.

Deliverable: Overturned Denials & Contract Settlements
04
Days 76 – 90+

Reconciliation & Clean Hand-Off

Final zero-balance reconciliation of workqueues. Post-audit executive briefing delivered to C-suite with documented root-cause cures. Unworked legacy backlog is eliminated, and stabilized queues are handed back to internal staff with zero disruption.

Deliverable: 85%+ Net Cash Collected & Clean Ledger Exit
Executive Financial Modeling • Risk-Free Contingency Yield

EBO Aged Backlog Cash Recovery Calculator

Configure your hospital network or physician group's aged receivables parameters below to calculate estimated net cash collections, avoided write-offs, and your projected time to portfolio liquidation.

1. Configure Aged Backlog Ledger

$14,500,000
Range: $1M specialty group to $50M health system backlog
120 – 180 Days
1 = 90-120d, 2 = 120-180d, 3 = 180-365d, 4 = 365d+
Nova Arc EBO Cash Acceleration Model

Projected Cleanup Yield

Projected Net Cash Recovered
+$8,990,000
62.0% Historical Recovery Yield on 120-180d aged claims
Avoided Timely-Filing Write-Offs: $5,510,000
Prevented from aging into permanent bad-debt loss
Projected Liquidation Velocity: 90 Calendar Days
Zero disruption to daily hospital billing staff
Contingency Engagement Model: $0 Upfront Risk
Fees paid strictly as a percentage of cash settled into your bank
Request Backlog Liquidation Proposal →
Specialized Skillsets • Certified Domain Expertise

Nova Arc Specialized EBO Surge Pods

Generic temporary billing agency workers lack the specialty expertise to overturn complex clinical denials. Nova Arc deploys credentialed, domain-specific revenue pods tailored to health systems and hospital-based specialties.

Sector: Health Systems & Acute Inpatient

Inpatient Clinical Denial & DRG Acuity Appeal Pod

Historical Overturn Rate
84.2% Overturned

Specialized Scope of Work

Staffed by certified registered nurse auditors (RN) and AHIMA-credentialed inpatient coding specialists. Investigates clinical downcoding, sepsis criteria disputes, observation-to-inpatient 2-midnight denials, and Medicare RAC Additional Documentation Requests (ADR).

Operational Methodology & EHR Integration

  • Retrieves certified EMR clinical records directly inside Epic or Cerner;
  • Compiles evidence-based clinical appeal packages citing Milliman Care Guidelines (MCG) or InterQual;
  • Coordinates physician peer-to-peer discussions within statutory windows;
  • Tracks administrative law judge (ALJ) Medicare hearing deadlines.
Proven Performance • Real-World Case Studies

Proven Backlog Liquidation for Health Systems & Groups

Health Systems 75-Day Cleanup

4-Hospital System ($520M NPR) — Post-Epic Go-Live Backlog

The Challenge: Following an enterprise Epic migration, workqueues swelled with $18.4M in stalled legacy accounts exceeding 120 days. Internal staff were overwhelmed by new system workflows and could not touch aged claims.

Outcome Under EBO Surge:
  • Liquidated 88% of legacy backlog in exactly 75 days;
  • Recovered +$13.2M in net cash deposited directly to hospital bank;
  • Added zero permanent FTE overhead; core staff maintained 99% current billing.
Hospital-Based Groups 90-Day Contingency

65-Physician Hospital-Based Anesthesia & Radiology Group

The Challenge: Commercial payers misapplied Multiple Procedure Payment Reductions (MPPR) to professional interpretation claims (Modifier 26) and truncated anesthesia minutes, trapping $4.8M in aged accounts past 150 days.

Outcome Under EBO Surge:
  • Dispatched contractual demand dispute packages across 82 commercial batches;
  • Recovered +$3.4M in trapped contractual cash on pure contingency;
  • Corrected payer claims engine logic, preventing ongoing monthly underpayments.
Engagement Clarity • Executive Answers

Frequently Asked Questions on EBO Surge Engagements

Liquidate Your Aged A/R Backlog on 100% Contingency

Schedule a confidential backlog evaluation with our revenue surge architects. We will analyze your aged trial balance, quantify collectible cash yield, and outline a custom 90-day time-boxed staffing overlay proposal within 5 business days.