Optimize the value of each referral. Every time. 

If you are navigating a difficult in-network referral, seeking an out-of-network authorization, or carving out a high-cost medication, Nova can provide the necessary support and experience to facilitate a desired outcome. This allows management and staff to focus on maintaining their day-to-day business performance.  

Additionally, Nova works hand in hand with hospital staff to establish and nurture positive relationships, impacting future referrals.

We understand the time-sensitive nature and respond accordingly utilizing clinical peer review with one on one case assessment.    

Difficult In-Network Referrals

• Establishing medical necessity

• Out of state admissions

• Retro-authorization approvals 

Out of Network Authorizations

• Single case agreements

• Supplement out of network authorizations during change of ownership process

• Out of state admissions

• Retro-authorization approvals

• Denial/Appeals

• Data collection for the negotiation process to acquire sought after contracts

High-Cost Medications

• Review of clinical to exercise due diligence for additional high-cost drugs

• In and out of network carve-out

• Prior authorizations when allowed by plan or policy guidelines to lighten staff case load