Case Studies
Real practices.
Real results.
Two engagements, what was wrong, what we changed, and what it produced.
Cardiology Practice
High denial rate on cardiology claims
- fewer denials
42%
fewer denials
- days in AR
22
days in AR
What we did
- Analyzed twelve months of denials and grouped them by root cause rather than by payer
- Found the majority traced to two upstream issues: component modifiers and diagnosis support on diagnostic tests
- Fixed the charge review step so both were checked before submission
- Reworked and appealed the recoverable backlog
Urgent Care Center
Aging AR from high-volume walk-in visits
- recovered
$85K
recovered
- clean claim rate
96%
clean claim rate
What we did
- Rebuilt eligibility capture at registration so coverage was confirmed before posting
- Built a clean claim process with payer-specific edits for S-codes and place of service
- Worked the aged backlog by value and age, with timely-filing protection on at-risk claims
- Set a standing follow-up cadence so nothing aged untouched again
What would yours look like?
Send a sample of your denials and aged AR. We'll tell you what's recoverable and what it takes.