Novus Health Systems

What Novus Health Systems does

Novus Health Systems is a privately held, California-based healthcare technology company founded in 2002 by Perry Beck and Jonathan Heath. The company is headquartered in Covina, California, and operates without disclosed external venture or private equity backing.

The company's core product is BillPro™, a proprietary web-based software platform purpose-built for Medi-Cal denial management and aged receivables follow-up. BillPro functions as a data aggregator that ingests Medi-Cal website data, SCPI/ARDS files, ANSI-835 remittance files, and hospital Patient Accounting Systems via web portal and SFTP. Its module set includes All-Payer Remits, Medicaid Tools & Templates (CIF, Appeal & LTC 25-1 forms, eligibility/TAR/claim status retrieval), Enhanced 835 File (with RAD code insertion), TAR/SAR Dashboard, Medicare Bad Debt Log, and Codes & Calculators. The platform also stores historical RA and claim data for indefinite, multi-criteria search. The platform is HITRUST Risk-based 2-year (r2) certified as of August 2022.

Novus monetizes through two streams: (1) BillPro subscriptions sold on a recurring basis to hospitals and healthcare providers in California, and (2) Receivables Management services, a no-risk managed service for back-end follow-up of aged Medi-Cal claims, billed on successful net collections. Go-to-market is sales-led and consultative, driven primarily by word-of-mouth referrals and direct outreach by senior executives. The company reports 150+ California hospital and provider subscribers with near 100% client retention, and a documented 4x efficiency gain among clients. There is no evidence of geographic expansion beyond California or vertical expansion beyond hospitals and healthcare providers.

Name

Novus Health Systems

Legal name

Novus Health Systems

Website

https://nhsystems.net

Company type

Private

Founded year

2002

Operating status

Operating

Headcount range

11–50 employees

Short description

Novus Health Systems is a privately held California company that sells BillPro™, a subscription-based Medi-Cal denial management and receivables follow-up platform, plus success-fee managed services, to hospitals and healthcare providers in California.

Ownership category

akta.pro rank

Product category

Healthcare Revenue Cycle Management Software

NAICS

Computer Systems Design and Related Services (54151), Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (518)

SIC

Services-Prepackaged Software (7372), Hospital & Medical Service Plans (6324)

akta.pro industry

PRIMARYHLACACAJ

Accounts Receivable (A/R) & Collections Management

Healthcare & Life Sciences/Digital Health & Health IT/Revenue Cycle Management (RCM) & Billing Software

SECONDARYHLACACAG

Patient Billing, Statements & Payment Processing

Healthcare & Life Sciences/Digital Health & Health IT/Revenue Cycle Management (RCM) & Billing Software

SECONDARYFSAKAJAM

Medical Debt Collection & Revenue Cycle Bad-Debt Recovery

Financial & Insurance/Lending & Consumer Finance/Debt Collection, Recovery & Servicing

Keywords

• Medi-Cal billing software
• Denial management software
• Healthcare revenue cycle
• Medicaid receivables management
• TAR SAR tracking

Headquarters

HQ city

Covina

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Software

Cost components

Personnel, Technology or R&D, Operations, Marketing or Sales, Infrastructure

Revenue model

1. BillPro Subscriptions: Subscription-based access to proprietary BillPro software platform providing Medi-Cal/Medicaid billing tools, denial management, and follow-up automation. Access to web-based tools including All-Payer Remits, Medicaid Tools & Templates, Enhanced 835 File, TAR/SAR Dashboard, Medicare Bad Debt Log, and Codes & Calculators.
2. Receivables Management Services: Back-end follow-up of aged Medi-Cal receivables. No-risk service with fees based solely on successful net collections. Includes front-end billing with follow-up handling Medi-Cal and Medi-Cal Managed Care billing from claim submission through resolution.

Go-to-market motion1 record

Distribution channels3 records

Marketing channels3 records

Core offering

Novus Health Systems develops and licenses BillPro, a proprietary web-based software platform that automates Medi-Cal denial management and accounts receivable follow-up for hospitals. The platform ingests data from Medi-Cal provider portal websites (via automated login), SCPI/ARDS eligibility files, ANSI-835 remittance files, and hospital patient accounting system feeds, and provides specialized modules including a TAR/SAR Dashboard, an Enhanced 835 Module, and a Medicare Bad Debt Log. The company also provides Receivables Management services that perform back-end follow-up of aged Medi-Cal receivables on a contingency-fee basis.

Product overview

Novus Health Systems offers BillPro, a subscription-based proprietary software platform designed for Medi-Cal/Medicaid denial management and receivables follow-up. The platform consists of core product BillPro™ and integrated modules including All-Payer Remits (electronic RA data services), Medicaid Tools & Templates (CIF, Appeal & LTC forms), Enhanced 835 File, TAR/SAR Dashboard, Medicare Bad Debt Log, and Codes & Calculators. The platform is delivered via web-based subscription with SFTP-based data exchange for hospital integration.

Differentiator

Problem solved

Functional benefit

Brands

• BillPro™: A web-based software platform designed to support Medi-Cal denial management efforts. BillPro is a data aggregator that allows billing and follow-up staff to accomplish more tasks in significantly less time compared to conventional processes. Over 150 hospitals and providers in California subscribe to BillPro.

Products and services

• BillPro BillPro is a proprietary web-based software platform that automates Medi-Cal (California Medicaid) denial management and accounts receivable follow-up for hospitals and health systems. It aggregates data from Medi-Cal provider portal websites via automated login, SCPI/ARDS eligibility files, ANSI-835 electronic remittance advice files, and hospital patient accounting system feeds to produce actionable denial and AR work queues for hospital revenue cycle teams.
• BillPro TAR/SAR Dashboard A BillPro module that tracks and manages Treatment Authorization Request (TAR) and Service Authorization Request (SAR) submissions to Medi-Cal, providing visibility into authorization status and supporting timely follow-up. It is used by hospital patient financial services and utilization management staff handling California Medicaid authorizations.
• BillPro Enhanced 835 Module An add-on capability within BillPro that provides enhanced processing and presentation of ANSI-835 electronic remittance advice files, enabling hospital revenue cycle staff to better reconcile Medi-Cal payments, adjustments, and denial codes.
• BillPro Medicare Bad Debt Log

Quantifiable outcome

• Efficiency increased by factor of four
• +2 more outcomes

Segments1 record

Ideal customer profiles1 record

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature8 records

Scale indicators3 records

Recent moves5 records

Expansion highlights4 records

Broad incumbents

• R1 RCM: R1 RCM (now TowerBrook/CD&R-backed) is a large-scale revenue cycle management vendor serving U.S. hospitals with end-to-end billing, denials, and receivables services — directly comparable end market to Novus, though operating at vastly greater scale and across multiple payers/states.
• Cognizant TriZetto: TriZetto provides claims processing, payer administration, and provider RCM solutions for healthcare organizations — comparable to BillPro in handling remittance, eligibility, and claims workflows, though typically at health-plan scale.
• Experian Health: Experian Health offers RCM, claims management, and patient access solutions to hospitals and providers, with capabilities in denials, eligibility, and remittance similar to BillPro's modules but at national scale rather than California-Medi-Cal specific.
• Optum (UnitedHealth Group): Optum's RCM and healthcare technology services span denials management, claims processing, and analytics for providers — a broad incumbent competitor with the scale and capital Novus lacks, though less specialized in California Medi-Cal.
• Epic Systems: Epic's hospital EHR includes built-in billing, denial, and claims modules that compete for the same hospital IT wallet as BillPro, and many California hospitals already run Epic — making it a system-of-record incumbent.
• Availity: Availity operates a healthcare information network and provider/payer data exchange platform with denial and eligibility workflow tools, addressing similar provider back-office problems as BillPro but from a network/data exchange angle.
• Waystar: Waystar provides a cloud-based RCM platform covering claims management, denial resolution, remittance processing, and patient payment — overlapping with BillPro's core modules but as a broad, multi-payer suite rather than a Medi-Cal specialist.

Regional players

• MedSphere: MedSphere and similar smaller RCM/EHR-adjacent service vendors target community and mid-sized hospitals with denial and receivables support — a comparable scale and customer segment to Novus's 150-hospital California footprint.

Direct peers

• Quadax: Quadax delivers healthcare revenue cycle management, EDI, and denial management services to hospitals and providers — a smaller, more specialized RCM peer with a comparable niche-services profile to Novus.
• Streamline Health: Streamline Health offers RCM solutions including denials management, coding, and revenue integrity to hospitals — overlapping directly with BillPro's denial management and receivables automation value proposition for providers.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/feed/update/urn:li:activity:6965044476721389568

Revenue estimate

Valuation estimate

Number of profiles

Profiles3 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Novus Health Systems