Turning Patient Navigation Into Measurable Clinical and Financial Value

G0023 / G0024 results in a multi-site program

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Generated

>$ 200 K

Collections

2 + YRS

Program

G 23 / 24

PIN Codes

Monthly 83

Billing Cycle

EXECUTIVE STATEMENT

In 2024 CMS made PIN work reimbursable by establishing both rules and CPT codes.

Clinical-i jumped right in to make PIN work visible, measurable and billable by tying navigation activity, time, documentation and monthly billing into one workflow. At one clinic the program has generated more than $200,000 in collections - showing that navigation can be clinically useful and financially sustainable.

Urology clinics who have not implemented PIN should contact Risk Assist MD at [email protected] they are leaving money on the table.

the case study

From impediment to impact.

Problem Statment

Navigation is real work, but much of it is invisible to the revenue cycle.
  • Calls, education, coordination, followup are constant.
  • Time/documentation hard to capture consistently
  • Eligible navigation work is missed at month end.

Consequences

When navigation is not captured at the point of work, clinics pay for it without seeing its full value.
  • Billable services are missed or delayed.
  • Leadership cannot see navigator workload or capacity.
  • Documentation gaps create avoidable billing friction.

One Continuous Execution Loop

Our Solution

Clinical-i turns navigator activity into an auditable monthly operating model.
  • Capture activity, time and outcome as work happens.
  • Track consent, eligibility and documentation gaps.
  • Reconcile billing & collections from the same activity.
Results + Measurability

Financial results are visible, and the operating model is measurable end to end.

>$ 200 K

Collected

Eligible 83

Patients Tracked

Nav Time 83

Minutes Tracked

BILL → $ 83

Conversion

Measured as patient → activity → time → billing → collection, with trends by provider, navigator and month.

Parallels across urology

One clinical model, across urology care

PIN supports urology cancers, BPH and OAB. Our execution model does not change.

What Stays Constant

Time capture → eligibility → consent → exception review → billing → collections.

What changes by condition

Condition-specific navigation tasks, qualifying diagnoses, clinical workflow, documentation and payer rules.

Conclusion

PIN demonstrates Clinical-i can convert invisible navigation work into auditable financial value.​

  • Navigation becomes measurable navigation — not an untracked overhead line.
  • The same operating model can support bladder cancer, prostate cancer, BPH and OAB programs.
  • Revenue, workload and closure can be evaluated from the same execution layer.

Clinical

Navigation work visible
Patient support documented

Operations

Workload measurable
Monthly workflow

Financial

>$200K collected
Revenue tied to activity

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Ready to Close the Loop?

Let’s build a care system where every test, follow-up, and communication is tracked — for better care and stronger risk management.

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