Five practices, and what actually changed.
Real numbers from real engagements, shared with permission. Where a practice asked not to be named we have given the specialty and the state instead.
Sixty-one thousand dollars was sitting in aged claims. We cleared it in ninety days.
They migrated EHRs in the spring and nobody reconciled the old ledger. Eighteen months of A/R was sitting in a system they had stopped logging into.
We rebuilt the whole ledger, appealed everything still inside its filing window, and told them honestly which claims were dead so they could stop hoping.
"They found money I had already grieved."
Two years of EAP sessions billed to the wrong entity.
Her EAP carve-out sessions had been going to the commercial plan since 2024. Every one came back denied, and she had assumed EAP work simply paid badly.
We rebilled everything still inside its window to the correct payer and set up a check at intake so it cannot happen again.
"I thought EAP just paid badly. It turned out I was billing it wrong for two years."
Authorisations kept expiring in the middle of a plan of care.
Nobody was tracking visit caps, so patients were being treated past their approved visits and the clinic was absorbing the difference.
We put every active plan of care on a tracked schedule with alerts at three visits remaining, and audited their 8-minute-rule unit counts while we were in there.
"We were treating for free and did not know it."
"My old company was perfectly competent. I just could never get anyone on the phone who knew my practice. That is the whole reason I left."
Credentialed from scratch with four payers in eleven weeks.
They had been quoted six months by another company and were four months in with nothing approved and no explanation.
We restarted CAQH, resubmitted three applications that had lapsed, and called each payer weekly until effective dates existed in writing.
"Eleven weeks after four wasted months. I still do not fully understand what they did differently."
A modifier error repeated since 2021, found in the first month.
Their telehealth claims carried a place-of-service and modifier pairing that one of their four payers had stopped accepting three years earlier.
The fix took an afternoon. The audit that found it is the one we run on every new account before we touch a single claim.
"That one fix paid their fee for the year."
Six more, unedited.
"Sami called me on a Sunday about eleven claims still inside their filing window. I have never had a biller call me on a Sunday."
Counselling · Columbus
"The monthly report is one page and I understand all of it. That sounds small. It is not."
Behavioral health · Portland
"Credentialing with four payers took eleven weeks. My last company quoted six months and never finished."
Group practice · San Jose
"They told me which claims were dead instead of billing me to chase them. Nobody had ever done that."
Counselling · Sacramento
"Zubair walked me through my own aging report line by line until I understood it. It took an hour."
Physical therapy · Denver
"Four years in and I still get the same two people. That is the entire review."
Private practice · Chicago
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