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Medical Billing Case StudyElevating Allergy Care: Expertise and Personalized Billing Solutions
Discover how Billed Right partnered with a Florida allergy practice to correct chronic coding issues, eliminate denial backlogs, and restore revenue cycle performance in under 6 months.
Our Client
A practice providing allergy services to patients using advanced technologies and a multi-disciplinary approach to allergy and immunology health. To serve their patients effectively, they deploy a full array of treatment modalities including allergy injections, pulmonary testing, and asthma treatments. Like many specialty practices, the physicians did not have the bandwidth to manage billing operations alongside patient care. They had previously outsourced billing to a vendor that was not delivering results.
Turning to Billed Right
- When they contracted with us, they recognized they needed true billing expertise, not just a vendor to process claims
- An onsite meeting was conducted, allowing us to get a deep understanding of their workflow, document all process improvement opportunities, and perform a comprehensive billing audit
- The review uncovered significant flaws in coding accuracy and a major discrepancy in how claims were being built, including missing codes, unfamiliarity with their practice management system, and billing practices that were costing the practice revenue daily. They chose Billed Right to fix it.
The Challenges
What was holding this practice back before Billed Right.
Coding accuracy was averaging between 50-70%, far below acceptable benchmarks for allergy billing
No systematic tracking process for allergy injections by treated condition, causing claim diagnosis errors
Lack of coding specificity throughout, especially for allergy-specific payer requirements
Increasing trend of denials, untitled claims, and rejected submissions with some claims aging 120+ days before being worked
Denial reason codes were unclear and not being used to drive corrective action
No integrated balance visibility between front desk operations and the billing team
Visit notes did not substantiate the level of care being billed
Billing documentation was never reviewed to address denial patterns
Accounts receivable extending beyond 90 days with no systematic follow-up or revalidation process
Office manager spending 50%+ of time on billing errors instead of front-end operations
Clean claim rate well below market benchmarks for the specialty
No standardized billing processes across the practice
Inability to consistently collect patient responsibility balances
No coding specificity applied to payer-specific requirements
In-network vs. out-of-network status not consistently verified or applied
Our Response
What Billed Right implemented to turn performance around.
- Focused first on bringing physicians back into coding compliance, implementing weekly coding education sessions to help physicians identify and correct documentation gaps relative to CPT codes, making coding accuracy the primary corrective priority
- Communicated LCD guidelines for all top-treated allergy conditions to enhance coding specificity and address co-conditions across multiple treatment categories
- Instituted a daily report of all unresolved claims with assigned task management, targeting less than 5% of claims unfinished at the end of each 24-48 hour window
- Immediately re-worked all previous denials and processed them for resubmission, addressing all outstanding denial inventory within the first 24-48 hours of engagement, including third-level appeals where necessary
- Categorized and organized all denials by type and root cause, corrected insurance and Medicaid information errors, and resubmitted all affected claims aligned to payer records
- Standardized all charge submission handling and clearinghouse rejection resolution, creating a repeatable workflow that eliminated the ad-hoc approach that had been allowing errors to compound
- Conducted weekly client education sessions to address billing and coding issues in real time, ensuring timely sign-offs and ongoing compliance education for clinical and administrative staff
The Results
Measurable outcomes achieved within 5 months of engaging Billed Right.
Why This Client Chose Billed Right
Solution-Oriented Approach
We are in business to find solutions to your billing needs, not to process claims and move on. Every engagement begins with understanding the specific issues driving revenue loss.
Holistic Growth Focus
We help allergy practices grow and keep your overall practice success in mind, not just your billing rate. Our goal is to be a long-term partner, not a transaction.
Ongoing Commitment
We continue to work with this client on:
- Workflow optimization across front desk and billing operations
- Claim denial management and root cause tracking
- Periodic practice performance evaluation meetings
- Monitoring claims for reimbursement from existing AR
- Client education on billing and coding updates specific to allergy
- Weekly, monthly, and quarterly financial report analysis and review
Billing inefficiencies do not have to hold your allergy practice back. With the right approach you can improve reimbursements, reduce denials, and bring your AR under control. Let Billed Right help you do the same.
Common Questions About This Case Study
The practice's prior billing vendor left coding accuracy averaging only 50-70%, with no systematic tracking of allergy injections by treated condition, unclear denial reason codes that were never used to drive corrective action, and claims aging 120 or more days before anyone worked them. The office manager was spending more than half her time on billing errors instead of front-end operations.
Billed Right first brought physicians back into coding compliance through weekly coding education sessions that helped them identify and correct documentation gaps relative to CPT codes. The team also communicated LCD guidelines for the practice's top-treated allergy conditions to improve coding specificity and properly address co-conditions across multiple treatment categories.
The practice's collection rate improved from 87% to 94% within five months of engaging Billed Right, alongside a 13% reduction in denials and reductions of up to 57% in aged accounts receivable.
Billed Right immediately reworked all previous denials and processed them for resubmission, addressing the full outstanding denial inventory within the first 24 to 48 hours of engagement, including third-level appeals where necessary. Denials were then categorized by type and root cause so insurance and Medicaid record errors could be corrected at the source rather than repeating claim by claim.
Yes. Billed Right conducts weekly client education sessions to address billing and coding issues in real time, ensuring timely documentation sign-offs and ongoing compliance education for both clinical and administrative staff, since allergy-specific coding and payer requirements continue to evolve.
Related Resources
Allergy & Immunology Billing Services
Learn how Billed Right handles billing for allergy and immunology practices.
Learn moreDenial Management Services
How we systematically reduce denials across every practice.
Learn moreAR Follow-Up Services
See how our AR Rescue Team recovers aged claims.
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