A rigorous, data-driven diagnostic evaluation of your revenue cycle operations. Nova Arc mines 12 to 24 months of raw EDI 837/835 remittance data, benchmarks your performance against national peer percentiles (HFMA MAP & MGMA), and architects an unbiased, vendor-neutral technology stack to eliminate silent revenue leakage.
When collections drop or days in A/R rise, organizations often implement superficial fixes—hiring more billing clerks, switching collection agencies, or buying bolt-on software. Without a scientific diagnostic, leadership treats symptoms rather than the root-cause friction silently draining 3% to 8% of earned revenue.
Most revenue leakage occurs at the boundary between departments: when registration errors bypass clinic intake, when coding queries languish in physician in-baskets, or when clearinghouse rejections sit in unmonitored queues. Our audit maps every handoff to isolate exactly where clean claims derail.
Comparing your performance only to your own historical numbers creates an illusion of stability. If your days in A/R have been 48 days for three years, internal reports show consistency—while peer MGMA and HFMA top-quartile performers are collecting cash in 29 days and operating with 30% lower cost-to-collect.
Healthcare providers spend thousands monthly on overlapping software tools (clearinghouses, patient portals, bolt-on scrubbers, eligibility widgets) that fail to communicate. Our technology framework evaluates true ROI, eliminating redundant licensing and activating native EHR capabilities.
Our diagnostic methodology combines forensic electronic remittance mining with on-the-ground operational workflow shadowing to evaluate every touchpoint from patient scheduling to balance resolution.
Securely extract 12 to 24 months of raw ANSI X12 837 claim files, 835 electronic remittances, appointment logs, and aged A/R trial balances via secure SFTP. Our algorithms parse millions of line items to reconstruct your historical baseline.
Virtual or on-site shadowing across the four core pillars: Front-End Intake & Auth, Mid-Cycle HIM/Coding, Central Business Office Billing, and Back-End Collections. We document staff workflows, handoff friction, and manual workarounds.
Correlate qualitative operational gaps with forensic remittance data. Quantify exact dollar leakage across: registration defects, timely filing write-offs, underpayment variances, unbilled implant charges, and patient bad-debt attrition.
Executive presentation to C-suite and board. Delivers prioritized quick-hit cash capture wins (30-day), strategic workflow redesigns (90-day), and a vendor-neutral technology stack optimization blueprint with guaranteed ROI.
Select your healthcare sector below to examine how national peer percentiles compare against Nova Arc's Top-Decile Best-in-Class benchmarks across 8 critical revenue cycle dimensions.
| Core KPI Dimension | 25th Percentile (Laggard) | 50th Percentile (National Median) | 75th Percentile (Strong) | Nova Arc Best-in-Class (Top 10%) |
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Technology should automate labor, not create administrative burden. Nova Arc provides vendor-neutral architectural evaluations to streamline your software ecosystem across five critical functional layers.
The central clinical and billing ledger. We evaluate how effectively your organization leverages native workqueues, charge routers, scheduling templates, and master patient indexes (MPI).
The conduit for ANSI X12 270/271, 837, 835, and 276/277 transactions. We analyze custom edit capabilities, real-time response latency, payer connectivity breadth, and clearinghouse rejection visibility.
Automates cognitive billing tasks: algorithmic clean-claim scrubbing, predictive denial modeling, autonomous EDI 278 prior authorization, CAC clinical coding, and automated appeal generation.
Patient-facing payment tools: SMS text-to-pay links, pre-service cost estimates, card-on-file tokenization, digital payment plans, and seamless credit balance refund disbursement portals.
Executive decision support: automated HFMA MAP tracking, denial root-cause clustering, payer contract variance alerts, and rolling 90-day cash flow predictive models.
Our evaluation delivers an unbiased roadmap: when to leverage native EHR modules (saving licensing fees), when to deploy specialized best-of-breed bolt-ons (for high ROI), and how to bridge gaps using modern FHIR APIs rather than brittle RPA screen-scraping bots.
Configure your organization's annual revenue and performance parameters below to estimate total uncaptured revenue leakage and working capital trapped in aging receivables.
Our diagnostic methodology is sector-agnostic because revenue cycle mathematics apply universally. Examine how different healthcare sectors leveraged our workflow audit and tech recommendations.
Audit Finding: A 14-day diagnostic identified that surgical implant charges (HCPCS C-codes) were failing to cross the charge interface from OR supply tracking into Epic Resolute, creating $8.4M in unbilled Discharged Not Final Billed (DNFB) leakage.
Audit Finding: Tech stack review revealed the ASC was paying $18,000/mo for three disconnected bolt-on scrubbing and eligibility tools. Clearinghouse edits were misaligned with commercial surgical bundling rules, causing a 16.4% first-pass denial rate.
Audit Finding: KPI benchmarking against MGMA top-decile cardiology practices revealed systematic CARC 97 bundling denials on same-day E/M visits with diagnostic ultrasounds (CPT 93306), due to omitted Modifier 25 documentation.
Schedule a confidential scoping call with our senior revenue cycle architects. We will define data extraction protocols, establish timeline deliverables, and show you how national peer benchmarking can transform your cash collections.
