The Overview

This Nirvana Partner is one of the largest behavioral health organizations in the country serving more than 100,000 patients annually. Between 2023 and 2024 this organization experienced a 46% increase in the number of policies requiring manual verification.

While this growth was positive in terms of the health of the business, it was now a significant strain on billing team resources. To compound the 46% workload increase, the billing team was short-staffed by 5 headcount, at the busiest time of year with annual plan resets occurring in January.

This practice needed a benefit verification solution that could scale efficiently with their company.

The Solution

They implemented Nirvana’s AI-powered benefit verification and continuous coverage monitoring via direct integration with their existing EHR platform Veradigm. Integrating Nirvana provided instant benefit verification and cost estimates at intake for patients as well as proactive plan flagging triage tools enabling the partner to deal with the most time-sensitive cases ASAP.

The integration helped the billing team reduce the administrative burden of running manual checks, and transformed the efficiency of the team with biller-specific prioritized workflows.

The Outcome

+110% efficiency

Increase in biller efficiency at the organization.

+21,000

Claims identified as at risk of denial preventing downstream revenue loss.

Savings on overhead

An automated verification process and continuous coverage built for long-term practice growth.

“Nirvana helps us get information upfront and empowers our providers to have conversations with our clients proactively…. We have already seen decreased denials and increased turnaround times in identifying insurance changes. Nirvana helps us fulfill our mission, which is to make getting help easy.”