How ENT and Allergy Associates Automatically Corrects 82% of Claim Errors
ENT and Allergy Associates (ENTA), the largest ear, nose, and throat practice in the U.S. with 50+ locations and 240+ physicians, achieved an 82% automation rate in billing corrections—without hiring a single additional staff member. Faced with staffing shortages and increased operational strain during the COVID-19 pandemic, ENTA partnered with NextGen Healthcare to rethink their revenue cycle from the inside out.
By implementing the NextGen® Charge Review Rules Engine, ENTA was able to:
- Automatically correct 82% of claim errors before submission, requiring staff intervention on only 18% of cases
- Eliminate the labor-intensive charge void and re-entry process
- Reduce claim processing time to 6–8 hours, including selective holds for real-time correction
- Free up office staff to focus more on patient care and less on manual billing corrections
The customizable rules engine not only improved clean claims but also added a compliance layer—enabling coding experts to help educate providers as payer policies evolve. The results: faster reimbursements, cleaner A/R, and higher staff satisfaction.
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