Healthcare RCM Case Studies
Explore how our expert revenue cycle management solutions helped healthcare organizations reduce denials, improve coding accuracy, accelerate reimbursements, and increase overall collections through structured workflows and dedicated support.
Green Valley Multi Specialty Clinic
Challenges
- Denial rate: 17.8%
- Avg. payment turnaround: 43 days
- Coding accuracy: 84%
- A/R over 90 days: 22%
- Slow prior authorizations
Our Approach
- Real time scribing + structured documentation
- Coding audits + dual layer checks
- Dedicated authorization desk
- Daily claim reviews
- Weekly A/R clean up
| Performance Area | Before | After |
|---|---|---|
| Denials | 17.8% | 5.9% |
| Payment Turnaround | 43 Days | 18 Days |
| Coding Accuracy | 84% | 98.1% |
| A/R 90+ | 22% | 9% |
| Authorizations | 3–5 Days | 24–48 Hrs |
| Monthly Collections | — | ↑ 27% |
Client Feedback
“Within two months, our financial performance stabilized. Their accuracy and communication are excellent.”
Lakeside Orthopedic & Sports Medicine Center
Challenges
- Coding errors: 21%
- Rejected claims: 14.3%
- Missing surgery charges: 8–10%
- A/R 60–90 days: 29%
Our Approach
- Ortho trained coders
- Standardized op-note templates
- Daily surgery to charge reconciliation
- Modifier accuracy checks
| Performance Area | Before | After |
|---|---|---|
| Coding Accuracy | 79% | 97.6% |
| Rejections | 14.3% | 4.1% |
| Charge Capture | — | ↑ 11% |
| Payment Turnaround | 38 Days | 17 Days |
| A/R 60–90 | 29% | 11% |
| Monthly Revenue | — | ↑ 31% |
Client Feedback
“They understand orthopedic billing extremely well, and the reduction in denials was immediate.”
HeartCare Cardiology Institute
Challenges
- Stress test denials: 22%
- EKG/echo documentation gaps
- Authorization delays: 4 days
- Undercoded cardiac procedures
- 1,200 claim backlog
Our Approach
- Cardiology coders
- Structured echo/EKG workflow
- Dedicated cardiac PA desk
- Weekly backlog cleanup
| Performance Area | Before | After |
|---|---|---|
| Stress Test Denials | 22% | 7% |
| Authorization Time | 4 Days | 36 Hours |
| Coding Accuracy | 86% | 99% |
| Claim Backlog | 1,200 Claims | Cleared in 21 Days |
| First Pass Approval | 69% | 93% |
| Monthly Revenue | — | ↑ 24% |
Client Feedback
“Authorizations became fast and smooth. Coding accuracy improved dramatically.”
Sunrise Family Health Clinic
Challenges
- Documentation errors causing stalled claims
- Preventive visit coding errors: 16%
- Denials for wellness exams: 12%
- Eligibility issues causing rescheduling
- Slow patient billing follow up
Our Approach
- Clean wellness/chronic care templates
- Coding fixes for preventive + problem visits
- Weekly denial breakdown
- Patient billing support
- Automated eligibility checks
| Performance Area | Before | After |
|---|---|---|
| Documentation Denials | 12% | 3.2% |
| Coding Accuracy | 82% | 97.4% |
| A/R 90+ | 19% | 7% |
| Patient Collections | — | ↑ 22% |
| Eligibility Errors | High | ↓ 90% |
| Monthly Revenue | — | ↑ 18% |
Client Feedback
“Our preventive visit claims finally stopped getting denied. The improvement was quick and visible.”