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Medical Billing Case StudyTransforming Primary Care Revenue Cycle Management with Billed Right
This case study highlights a primary care group that partnered with Billed Right to tackle inefficient billing, lack of transparency, and workflow gaps, then saw measurable results within 6 months.
Our Client
This two-provider group delivers high-quality, personalized primary care. They specialize in diagnosing and treating various medical conditions and offering preventive care services for both acute and chronic illnesses.
Turning to Billed Right
- This client sought our expertise after their long-term Office Manager left the practice unexpectedly
- Without any insight into their billing operations, they faced unpaid and denied claims, poor reconciliation processes, and significant workflow inefficiencies
- Faced with compounding billing challenges and declining collections, they chose to partner with Billed Right
The Challenges
What was holding this practice back before Billed Right.
Lack of knowledge about billing operations after office manager departure
Numerous unpaid claims accumulating without follow-up
Many rejected claims at the physician level going unaddressed
Inconsistent eligibility and benefits verification at point of service
Under-utilization of the practice management system capabilities
Limited financial reporting visibility for the physician owners
High number of denied claims with no denial management process
Lack of reconciliation of charges to payments
High amount of patient accounts receivables aging past 90 days
Unfamiliarity with financial reports available in their practice management system
Our Response
What Billed Right implemented to turn performance around.
- Fully took over and quality-checked their practice management system for setup, activated unused modules, and created a new billing workflow integrated with front desk operations
- Deployed our AR Rescue Team to identify all reasons for non-payment, corrected them, and resubmitted claims systematically
- Set up scheduling and edit screening codes to capture errors before claim submission reaches the clearinghouse
- Initiated balancing, adjustments, and corrections to match beginning balances to ending reconciliation detail, establishing daily and weekly reconciliation reviews
- Initiated routine eligibility and benefits follow-up with insurance carriers to ensure patient information is current before every visit
- Segregated all clearinghouse rejections, standardized error messages and rejection descriptions, and scheduled validation edits to prevent future claim issues
- Integrated a state-of-the-art patient statement design and process to improve patient collections
- Enhanced existing payment systems to improve patient satisfaction and payment collection rates
- Provided client education on additional uses of their practice management system, covering scheduling, charge capture, billing procedures, and reporting, for improved efficiency
- Provided weekly coding education to physicians to improve clinical documentation quality
The Results
Measurable outcomes achieved within 6 months of engaging Billed Right.
Why This Client Chose Billed Right
The Client Needed a Knowledgeable Partner
The client needed a partner who knew their software and could hit the ground running, understanding how each process worked and enhancing it from day one.
Billed Right Bridged the Gap
We helped bridge the gap in expertise and knowledge, guiding the practice back to financial health and helping them maximize their full revenue potential.
Ongoing Commitment
We continue to work with this client on:
- Workflow optimization and process improvement
- Claim denial management and coding accuracy
- Periodic practice performance evaluation meetings
- Identifying claims for reimbursement from existing AR
- Client education on billing and coding updates
- Monthly and quarterly financial report analysis and review
You can see the impact of our Primary Care Case Study approach: the same strategy is available for your practice.
Common Questions About This Case Study
The practice's collection rate improved from 84% to 95% within six months of engaging Billed Right. That timeline included taking over and correcting the practice management system setup, resubmitting outstanding claims through a dedicated AR recovery effort, and establishing new front-desk and billing workflows.
The practice lost its long-term office manager without warning and was left with no institutional knowledge of its own billing operations. That gap led to a backlog of unpaid and denied claims, no reconciliation process between charges and payments, and no one on staff who understood the reporting tools already available in their practice management system.
Billed Right segregated all clearinghouse rejections, standardized error messages and rejection descriptions, and set up scheduling and edit screening codes that catch errors before a claim ever reaches the clearinghouse. Combined with routine eligibility and benefits verification before each visit, this prevented the majority of denials from occurring in the first place rather than only working them after the fact.
The AR Rescue Team is a dedicated Billed Right function that audits an aged accounts receivable backlog claim by claim, identifies the specific reason each one went unpaid, corrects the underlying issue, and resubmits it systematically rather than in an ad hoc batch. For this practice, that process was central to cutting 31-90 day AR by 51%.
Billed Right works inside the practice's existing practice management system rather than requiring a switch to new software. In this case, that meant fully taking over and quality-checking the existing system's setup, activating modules the practice was not using, and training the client's staff on scheduling, charge capture, and reporting features already available to them.
Related Resources
Primary Care Billing Services
Learn how Billed Right handles billing for primary care practices.
Learn moreAR Follow-Up Services
See how our AR Rescue Team recovers aged claims.
Learn moreDenial Management
How we systematically reduce denials across every practice.
Learn moreReady to See Results Like These in Your Practice?
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