Real engagements, described by practice profile rather than by name. Each one shows the problem we found, what we changed, and the direction the numbers moved.
4-provider Mohs and general dermatology group, Southwest
Mohs practice cut surgical denials after repair coding rebuild
Staged Mohs cases were being submitted with incorrect block counts and repairs bundled into the excision, so a predictable share of the highest-value claims came back denied or underpaid every month.
What we changed
Prospective coding review on every Mohs case before submission
Rebuilt modifier sequencing for same-day biopsy, excision and repair
Repair sizing verified against operative note anatomic site
Appeal templates built per payer for bundling denials
Direction of results
Surgical denial rate
down materially
First-pass acceptance
improved
Days in A/R
reduced
“The difference was not that we started billing more. It was that the cases we were already doing finally got paid correctly the first time.”
Measurement window: First two quarters of engagement
2-location general dermatology practice, Northeast
Aged A/R recovery after a mid-year biller transition
The practice left a prior billing vendor with a large balance of claims past 120 days, much of it approaching timely filing limits with no documented follow-up history.
What we changed
Full A/R inventory triaged by payer, age and timely filing deadline
Reconsiderations filed first on claims closest to the filing window
Eligibility re-verified on accounts denied for coverage
Root-cause report delivered so the same errors did not recur going forward
Direction of results
Recovered balances
substantial recovery
Claims lost to timely filing
minimized
A/R over 120 days
reduced
“We assumed that money was gone. A meaningful share of it was not — it just needed someone to work it before the clock ran out.”
Measurement window: 90-day recovery project
6-provider dermatology group, Southeast
Office visit coding brought in line with documentation
Providers were defaulting to a single E/M level regardless of medical decision making, leaving legitimately supported visits undercoded across thousands of encounters a year.
What we changed
Retrospective audit sample across all providers
Provider-level feedback sessions with documented examples
EHR templates updated to prompt MDM elements
Ongoing quarterly audit cadence to hold the gain
Direction of results
E/M level distribution
aligned to documentation
Audit exposure
reduced both directions
Per-visit revenue
increased
“It was never about upcoding. It was about getting credit for the work already in the chart.”
Measurement window: One quarter to implement, ongoing audits
Medical dermatology practice with heavy biologics volume, West
Biologics authorizations moved off the clinical team
Nursing staff were spending hours each week on prior authorizations and peer-to-peer scheduling, and treatment start dates slipped when approvals lagged.
What we changed
Dedicated authorization queue with payer-specific criteria checklists
Benefit verification completed before the visit, not after
Peer-to-peer requests scheduled proactively on likely denials
Approval status visible to clinical staff without a phone call
Direction of results
Clinical staff hours on auth work
sharply reduced
Treatment start delays
shortened
Authorization-related denials
reduced
“Our nurses went back to being nurses. That alone justified the move.”
Measurement window: 60 days from go-live
Dermatology group with in-house dermatopathology lab, Midwest
In-house pathology billing corrected on TC/PC splits
Global billing was being submitted where payers required technical and professional components split, and multiple specimens from a single encounter were being underreported.
What we changed
Payer-by-payer determination of global versus split billing rules
Specimen-level charge capture reconciled against the lab log
Corrected claims filed within reconsideration windows
Monthly reconciliation between lab volume and billed specimens
Direction of results
Specimen capture
reconciled to lab log
Pathology underpayments
corrected
Lab revenue per encounter
increased
“The lab was doing the work. The claims just were not describing it accurately.”
Measurement window: First 120 days
Combined medical and cosmetic dermatology practice, South
Cosmetic and medical services separated cleanly at the front desk
Mixed visits produced disputed patient balances and payer refund requests, because cosmetic services were occasionally submitted to insurance and medical services were occasionally collected as cash.
What we changed
Service-level decision rules built with the clinical team
Financial responsibility forms revised and captured at check-in
Front-desk training on the medical-necessity determination
Patient statements redesigned to show the split plainly
Direction of results
Patient billing disputes
reduced
Payer refund requests
reduced
Point-of-service collections
improved
“Patients stopped calling angry, because the bill finally matched what we told them at check-in.”
Measurement window: One quarter
Why these are anonymized
Client practices are identified by size, service mix and region rather than by name. Naming a practice alongside its collections data reveals competitively sensitive financial information, and our agreements do not treat client performance data as marketing material.
Directional outcomes are described qualitatively rather than as headline percentages, because a percentage without the underlying baseline, payer mix and time period is not evidence. On a discovery call we will walk through the underlying numbers for a comparable practice.
How to read a case study
Match the profile first — provider count, service mix and region drive most of the result
Look at the actions, not the outcome; the actions are what we would repeat at your practice
Ask what the baseline was, and over what period the change was measured
Ask what did not work, and what the practice had to change on its side
Frequently asked questions
Why are the practices not named?
Client agreements treat performance and collections data as confidential. We describe practices by size, service mix and region instead, and we can discuss a comparable engagement in detail on a call.
Can you share specific numbers?
Yes, in a discovery conversation and under an NDA where appropriate. We prefer to show numbers with their baseline and time period attached rather than publish a headline percentage without context.
Can we speak to a reference practice?
We can arrange a reference call with a practice of similar size and service mix, subject to that practice agreeing.
How long before we would see similar results?
Denial and clean-claim improvements typically show inside the first 60 to 90 days. Aged A/R recovery is a defined project with its own timeline, and coding-driven changes hold only with an ongoing audit cadence.
Free claims audit
Find out exactly what your practice is losing.
Send a de-identified claims sample. Within five business days you get a line-item leakage report — coding gaps, underpayments, and recoverable aged A/R, in dollars.
No cost, no obligation, no sales pressure
BAA signed before any data is shared
Reviewed by AAPC-certified dermatology coders
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