You handle the patients. We'll handle the business.
We take pride in helping our clients pick up the slack where they need it, when they need it.
Whether we’re talking about services adjacent to billing/revenue cycle management, staffing, training, operational development, or more involved strategic planning and action, we can help. Anything boring or back-office, we’ve got you!
Need your cases approved? Do you need to know if they're even worth submitting so you don't waste time? Our team of RNs has a 99% approval rate.
Once your case is covered, it is equally important to know what your patient may owe so that you can collect upfront. No more chasing down bills on the back end. Our Authorizations come with a benefit estimate included every time.
Are you out-of-network, but just taking shots in the dark at what might pay? Let our team price that case up front so you know what it could be worth; no more guesswork.
Let our experts help your sales team with how to explain the process, decide which cases are worth it, and set the expectation for your patients to have a stellar experience instead of a complaint after the fact.
NGA Healthcare offers a turnkey solution for negotiating your rates and guarantees that will result in a meaningful rate increase for your practice. If you achieve no growth, there is no cost to you. There is virtually no risk in working with NGA on your rates. NGA Healthcare has successfully negotiated a rate increase for 100% of our clients. Please schedule a complimentary consultation to learn how we can help increase your bottom line.
What, you thought we did it all ourselves? When we can’t be the best, we partner with the best.
The APX Platform is a cloud-based business intelligence, training, educational, and data analytics solution for aesthetic practices. The easy-to-use APX Platform optimizes employee productivity and enhances practice profitability through training, analytics, and community engagement.
Looking for RCM/Billing training? Guess which talking head features on APX for that topic…
Seeking a new front desk candidate? New nurse? Manager or Patient Care Coordinator? Physician? We staff from front to back.
Staffing is only half the battle. How do you keep your team informed about how to handle your processes? Nothing worse than throwing a new team member into a trial by fire situation. Let our team help yours get acclimated.
Raise your hand if you don't have your processes written down. Do you have them documented in a way that allows someone to learn from them? Or have any training collateral? We can build that.
Are you unsure if your team is running things efficiently? We can assess your process, recommend changes, implement improvements, and equip you with the ability to track how your team is operating using KPIs.
KPI = Key Performance Indicator
You should call us if that were an airball for you.
Tired of things breaking being your sign to ask for a fix? Most practices lack HIPAA compliance, as well as security, reliability, and redundancy in their IT infrastructure. Not every IT problem is a nail, and most IT companies only operate like a hammer. Let our team provide you with the information you need.
HIPAA =
…you must know this one…right?
Credentialing gets your providers enrolled and approved with insurance payers; contracting negotiates the agreements that set what those payers actually pay you. Together they decide which patients you can see and what every visit is worth — done slowly or badly, they choke a practice’s revenue before a single claim goes out.
Yes — new practices getting on payer panels for the first time, established practices adding providers or locations, and groups expanding their payer grid. We handle the paperwork, the follow-up, and the timelines so enrollment never becomes the reason revenue waits.
We benchmark your current rates against what payers actually pay comparable practices, then renegotiate the underperformers. Most practices sign payer contracts once and never revisit them — which means years of underpayment on autopilot. Renegotiation is one of the only ways to raise revenue without seeing a single extra patient.
Prior authorization is the payer’s sign-off, before you operate or treat, that a procedure is covered. Miss it, botch it, or file it late and the claim can be denied outright — no matter how well the procedure was performed or coded. It’s one of the most common and most preventable ways surgical practices lose revenue.
Procedures like breast reduction and panniculectomy live or die on documented medical necessity — symptom history, conservative-treatment records, and criteria like the Schnur scale for reductions. We build the auth to the payer’s own criteria before submission, so approval is the expected outcome instead of a coin flip.
Biologics like Dupixent and JAK inhibitors carry the heaviest prior-auth burden in dermatology — step-therapy requirements, failed-treatment documentation, and re-authorizations that expire mid-treatment. We track payer criteria per drug, assemble the documentation up front, and manage renewals so patients don’t get interrupted and revenue doesn’t stall.
For a growing list of procedures, yes — Medicare requires prior authorization for certain hospital-outpatient and ambulatory-surgical procedures, including several common in plastic surgery, and the list keeps expanding. The rules differ from commercial payers and change by setting, which is exactly why practices get caught. We track the current requirements so your cases don’t stall.
A global period is the window after a surgery — typically 10 or 90 days — during which routine follow-up care is bundled into the original procedure’s payment and can’t be billed separately. Bill inside it wrongly and you get denials; miss what’s legitimately billable and you leave money behind. Our free global period calculator tells you exactly when each patient’s window ends.
Directly: a provider who isn’t credentialed with a payer can’t bill that payer — every visit they deliver in the gap is revenue at risk or written off. Slow enrollment is one of the most expensive invisible problems in a growing practice, which is why we treat credentialing timelines as a revenue function, not paperwork.
We work inside your existing EHR and practice management stack rather than forcing a migration — your workflows, your data, our team operating within them. During onboarding we map your current setup and flag anything that’s costing you money before we change a thing.
