FRONT-END REVENUE ARCHITECTURE

Patient Access: Strengthening Revenue at the Point of Encounter

Over 80% of preventable claim denials originate during scheduling and registration. Nova Arc transforms patient access into a robust financial firewall, verifying coverage, securing prior auth, and calculating out-of-pocket costs before care is rendered.

Patient Access: Strengthening Revenue at the Point of Encounter
99.5%
Pre-service eligibility verification rate
<2 Hours
Average prior authorization turnaround time
86%
Reduction in registration-related claim denials
38%
Increase in point-of-service patient collections
PROACTIVE FRONT-END WORKFLOWS

Comprehensive Patient Access Capabilities

From initial scheduling to arrival, our technology and specialized access team verify every critical detail to ensure clean claim downstream processing.

Insurance Eligibility Verification

Automated EDI 270/271 real-time checks verifying active coverage, copays, deductibles, out-of-pocket limits, and network participating tiers.

  • Real-time 270/271 inquiries
  • Secondary/tertiary coverage checks
  • Benefit limit & tier confirmation

Prior Authorization Management

Proactive identification of procedure auth requirements, automated submission of clinical records, and tracking to eliminate auth-related denials.

  • Electronic EDI 278 transactions
  • Clinical document assembly
  • Payer follow-up & escalation

Patient Registration QA

Automated scrubbing of demographic details, address validation, subscriber ID format checks, and coordination of benefits (COB) review.

  • USPS address standardization
  • Subscriber ID pattern matching
  • De-duplication of MPI records

Financial Clearance & GFE

Accurate out-of-pocket cost estimates complying with No Surprises Act Good Faith Estimate mandates, providing full financial transparency.

  • No Surprises Act compliance
  • Real-time fee schedule calculation
  • Clear patient estimate delivery

Point-of-Service Collections

Equipping front-desk teams with compassionate payment scripts, flexible digital payment plans, and zero-interest financing options.

  • Front-desk collection scripts
  • Digital SMS/email payment links
  • Compassionate financial counseling

Medical Necessity & Order QA

Checking orders against National and Local Coverage Determinations (NCD/LCD) to ensure Advanced Beneficiary Notices (ABN) are signed when required.

  • NCD/LCD policy alignment
  • Automated ABN generation
  • Order accuracy verification
PREVENTION OVER CURE

Why Fixing the Front-End Yields the Highest RCM ROI

Reworking a denied claim costs an average of $25 to $40 in administrative labor. Resolving discrepancies prior to the patient encounter costs less than $2 and protects patient trust.

  • Stop Avoidable Front-End Denials

    Catch invalid subscriber IDs, terminated policies, and missing prior auth numbers before claims are ever created.

  • Protect Patient Satisfaction

    Eliminate surprise medical bills and awkward billing disputes with upfront, accurate out-of-pocket transparency.

  • Accelerate Upfront Cash Flow

    Collect patient copays, deductibles, and co-insurance at or before the time of service rather than pursuing self-pay debt.

  • Smooth Clinical Operations

    Ensure physicians and clinic staff are not interrupted by last-minute authorization cancellations on the day of care.

Why Fixing the Front-End Yields the Highest RCM ROI

Strengthen Your Point of Access and Eliminate Front-End Denials

Speak with our patient access architects to benchmark your registration accuracy and pre-service clearance rate.

Schedule Patient Access Diagnostic

Ready to Elevate Your Revenue Cycle Performance?

Speak with our senior revenue cycle architects for an objective operational diagnostic, baseline denial analysis, and customized ROI projection.