Overcoming reimbursement hurdles: How blueBriX transformed OVAAI’s back-office operations

Ohio Valley Asthma & Allergy Institute (OVAAI), led by Dr Krishna R Urval, is a healthcare provider specializing in allergy and immunology. OVAAI faced significant challenges in its revenue cycle management, particularly with the “buy-and-bill” process, where physicians buy medications upfront and seek reimbursements later from third-party payers. They chanced upon blueBriX particularly for pre-authorization of insurance and over time, blueBriX has become OVAAI’s go-to partner for everything related to billing. This journey has been a continuous learning and scaling process for both OVAAI and blueBriX. The challenges and solutions were non-linear, but within a short period of time, we adapted our RCM solutions to address the specific business and real-time issues of OVAAI. If your healthcare organization is facing any challenge with billing or reimbursement, our story below could be food for thought.

Quickly summarizing, to resolve the challenges OVAAI faced, blueBriX:

  • Developed robust protocols for managing the buy-and-bill injection process,including regular follow-ups and monthly high-dollar claims reports.
  • Implemented strategies to monitor non-participating payers and prevent future denials.
  • Introduced a proactive process to verify patient coverage before visits,reducing the incidence of coverage issues.
  • Addressed the specific claims submission and processing challenges with insurers, particularly around Anthem and Highmark.
  • Reduced AR days by implementing alternative methods for claim submissions and managing delayed payments due to external disruptions.