Real Health Systems. Real Audits. Measurable Financial ROI.
Review verifiable clinical and financial outcomes achieved by US healthcare systems utilizing Nousvia autonomous revenue cycle intelligence.
The Clinical & Financial Challenge
Facing a 28% HIM coder vacancy rate and a $4.2M backlog in unbilled outpatient surgical and ED charts, the health system was experiencing 6.8 days in Discharged Not Final Billed (DNFB) time. External outsourced coding vendors produced unacceptable error rates (14% audit failure).
The Nousvia Implementation
Implemented Nousvia Autonomous Medical Coding integrated directly into Epic Hyperspace via SMART-on-FHIR. Nousvia began by shadowing coders in the Emergency Department, validating accuracy before switching to direct-to-bill mode for all encounters exceeding 95% confidence.
“Nousvia solved our HIM staffing crisis without sacrificing clinical compliance. The AI reasons through our complex operative notes with precision that impressed even our most veteran coding auditors.”
The Clinical & Financial Challenge
Orthopedic and spine surgeries suffered a 19% cancellation rate due to delayed commercial payer authorizations. Clinic staff spent an average of 42 minutes per case on payer web portals and repetitive phone calls.
The Nousvia Implementation
Deployed Nousvia Prior Authorization Automation. Nousvia automatically extracts MRI findings, conservative physical therapy records, and surgeon clinical indications to file 278 authorization requests electronically within minutes of surgery scheduling.
“Our surgical schedule is full, our patients get timely surgeries, and our staff no longer spends their afternoons listening to insurance hold music. Nousvia is transformative.”
The Clinical & Financial Challenge
A surge in commercial payer denials for medical necessity and missing documentation eroded hospital operating margins to 0.4%. The manual appeals team could only address 35% of actionable denials before filing deadlines expired.
The Nousvia Implementation
Integrated Nousvia Intelligent Denial Management with Oracle Cerner. The predictive engine flagged at-risk claims prior to 837 drop, while the automated appeal generator created customized, literature-backed appeal packets for historical denials.
“Nousvia paid for itself in the first 45 days. The appeal letters it produces are better researched and faster than anything an overburdened human team could draft manually.”