This month we launched Behind the Claims, continued our roll out of Annual Benefit Reset automation, were featured in the Out-of Pocket Healthcare Newsletter and welcomed Robert Andrews to our Advisory Council.
Highlights
Annual Benefit Resets: Get set up before it's too late! With over 80% of policies resetting in December, our automation (via API or OneVerify) proactively verifies coverage–reducing denials, confusion, and manual work. Contact your CSM to confirm you’re set up before the reset period.
Behind the Claims Series: Diana Villagomez Zavala, Operations Lead at Brave Health, is our first feature in our new behind the claims series. Read Diana’s story to see how she thinks about her responsibility as the first point of contact in patient care.
In the mental health field, emotions can run high. You only have so much time before a patient doesn’t want to talk anymore. That’s why accuracy matters so much – getting it right the first time builds trust.”
Improvements
New: TPA Nirvana Payer ID Available 10/14 (API Only)
When Nirvana flags a TPA or carve-out, you’ll now receive the TPA’s Nirvana payer ID directly in the API response. This allows your team to configure a second eligibility check to automatically run a verification check for that carve-out, rather than relying on manual verification.
This feature can help save time and reduce manual checks, but it does require some configuration on your side. Please reach out to your CSM for guidance on setup.
In Other News
Read Nikhil from Out of Pocket’s take on Nirvana: Here
Welcome Robert Andrews: Former U.S. Congressman, Affordable Care ACT (ACA) author, and CEO of the Health Transformation Alliance joins our Advisory Council, bringing deep policy and leadership expertise. Robert has been a leading voice in shaping national healthcare legislation and reform in the past 3 decades and will continue to help Nirvana further our mission to rebuild trust in eligibility and coverage transparency.
Catch Our Team:
HLTH – Oct 19–22 – Las Vegas
BHB Invest – Oct 22–24 – Nashville
CALUCA – Oct 22–24 – San Diego
Radiology Society of North America – Nov 30–Dec 3 – Chicago
BHT – Nov 11–13 – San Diego
SERUCA – Nov 13–15 – New Orleans
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