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Nivonyx PRC (Purchased/Referred Care)

Nivonyx PRC (Purchased/Referred Care)

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1 - 10 practices use this product.

Built for Native American tribal health organizations participating in the Purchased/Referred Care program of Indian Health Service, Nivonyx’s PRC system facilitates PRC workflows, including integrated repricing of claims with Medicare-like rates.

Nivonyx’s PRC System offers your team the convenience of accessing the system through a common web browser interface. Technicians can work in multiple tabs or windows to process various claims simultaneously.

Each member of your PRC team will have their own dashboard where they can get a quick overall picture through snapshots views, or access recent claims, cases, and patients.

When it’s time to initiate contact, use customizable templates with mail-merge features to generate a tailored Word document with just a few clicks that can be easily sent to vendors or patients.

Eliminate the clutter of paper storage, and facilitate communication, with digital documents. Each technician in your PRC team can have access to uploaded documents stored in the system and connected to a patient, case, or claim.

Although team members may be distributed across various clinics, multiple technicians can view and access cases and claims, even taking over where another technician left off. The system stores a log of users and their activity for accountability and auditing purposes.

Find seamless integration with Nivonyx’s PRC System for locating various patient information. Look up contact, insurance, eligibility, and claims right from within the system.

As technicians enter HCPCS details on a claim, the system will calculate the Medicare-like rate and display it as an option that can be chosen, thus eliminating the need for searching outside the system or manually calculating rates.

Keep tabs on staff and clinic performance, amounts of PRC claims paid (by CPT code, vendor, patient, or clinic), and denials with Nivonyx’s PRC System reports. When payments are processed through the system, it can also report on budget balances. Nivonyx will create report templates for any future needs your organization might have.


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