Our work, in numbers.
Anonymized to protect our clients. References available on request. This is what happens when specialty claims are worked by people who know exactly where the money hides.
- Denial rate, by payer & code
- Days in A/R & aging buckets
- Net collection rate
Every engagement, measured.
- Behavioral Health · IOP/PHP
A multi-site group losing residential revenue to carve-out errors
Claims were routing to the medical plan instead of the behavioral carve-out, triggering timely-filing denials on high-dollar residential stays. We rebuilt verification and reworked 90 days of aged A/R.
Denial rate22%6%A/R > 90 days38%11%Recovered$0$540K - Inpatient Physician Billing · E/M
An inpatient physician group leaving revenue in the documentation
Initial and subsequent hospital care was being coded by method rather than by documented medical decision making, and concurrent-care denials went unappealed. We audited the E/M mix against documentation and rebuilt the leveling and appeal workflow.
E/M levelingBy methodBy documentationConcurrent-care denialsDeniedAppealedProfessional revenueLeakingRecovered - Mental Health · Group Practice
A psychiatry group defaulting every session to 90837
Uniform 90837 coding without documented time created audit exposure and denials. We introduced time-band coding, documentation feedback, and a clean telehealth grid.
Denial exposureMediumLowAudit riskHighLowNet collectionsLeakingCaptured
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