Case Studies
Discover how healthcare practices across the U.S. have boosted collections, cut denials, and streamlined their revenue cycle with ProCareMedEx’s expert billing solutions.
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Average Collection
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Increase
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Average AR
Reduction
Reduction
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Average Denial Rate
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Drop
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Client Retention
Rate
Rate
Cardiology | 12 Providers
Collections Up 34%
A 12-provider cardiology group across three locations faced high denial rates, slow payment posting, and an aging AR at 52 days. Their billing team was overwhelmed by claim volume and complex cardiac procedure coding. ProCareMedEx deployed cardiac coding specialists, real-time eligibility verification, and a denial prevention program. We established daily claim submission, prior authorization tracking for cardiac procedures, and payer-specific billing protocols for high-value services including cardiac catheterization and stress testing. Collections increased 34% and denial rates dropped from 18% to 4.2% within 6 months.
Net Collections
Before: $2.1M/month
After: $2.8M/month
+35
Days in AR
Before: 52 days After: 31 days
-40%
Denial Rate
Before: 18%
After: 4.2%
-77%
Clean Claim Rate
Before: 79%
After: 97%
+23%
Claims Recovered
Before: $0
After: $182,000
+$182K
Appeal Success
Before: 22%
After: 74%
+236%
Monthly Collections
Before: $890K
After: $1.15M
+29%
Authorization Denials
Before: 12%
After: 2%
-83%
Orthopedics | 5 Surgeons
$182K Recovered
An orthopedic surgery center had over $400K in denied claims across 18 months due to complex surgical coding errors, bundling issues, and inconsistent authorization processes. Staff had stopped appealing older denials entirely. ProCareMedEx launched a full AR recovery project, analyzing every denied claim by recovery probability. Our specialists corrected all coding errors and built detailed appeals with operative notes and medical necessity documentation. A prospective denial prevention system was implemented to protect future revenue, recovering $182K in written-off claims within just 4 months.
Mental Health | 8 Providers
AR Cut by 58%
A growing behavioral health practice with psychiatrists, psychologists, and therapists struggled with complex mental health billing. Varying payer rules across therapy sessions, medication management, and psychological testing created confusion. AR had ballooned to 67 days with collection rates declining. ProCareMedEx deployed mental health billing specialists with expertise in psychiatric coding, therapy billing, and psychological testing reimbursement. We introduced session tracking, improved documentation, and built payer-specific protocols for authorizations. Within 5 months AR dropped from 67 to 28 days and collections rose from 78% to 94%
Time to Payment
Before: 45 days
After: 18 days
-60%
Days in AR
Before: 67 days
After: 28 days
-58%
Claim Rejections
Before: 15%
After: 3%
-80%
Collection Rate
Before: 78%
After: 94%
+21%
Annual Billing Cost
Before: $480K
After: $240K
-50%
Days in AR
Before: 44 days
After: 32 days
-27%
Net Collections
Before: $8.2M
After: $9.4M
+15%
Denial Rate
Before: 11%
After: 3.8%
-65%
Primary Care | 20 Providers
$240K Saved
A multi-state primary care network with 20 providers spent over $480K annually on in-house billing with 6 full-time staff. Despite this investment, denial rates stayed at 11% and AR averaged 44 days. Constant turnover created training challenges hurting performance across locations. ProCareMedEx took over complete revenue cycle management, freeing the practice to redeploy billing staff into patient-facing roles. We standardized all processes, centralized credentialing, and delivered unified reporting giving leadership complete network visibility. Billing costs dropped 50% while collections climbed from $8.2M to $9.4M within the first quarter.
Dermatology | Solo Practice
$95K Recovered
A solo dermatologist spent 15+ hours weekly on billing instead of patient care. Procedure coding for dermatologic surgery, Mohs, and cosmetic services was inconsistent, leaving revenue uncaptured monthly. ProCareMedEx assigned a dermatology-specialized biller to her practice and conducted a complete audit of all existing coding practices. We identified significant undercoding across multiple procedure categories and corrected it entirely. Proper modifier usage was implemented, EM coding optimized, and pathology billing captured correctly. Within 3 months the provider recovered $95K in additional take-home revenue and reclaimed 15 weekly hours.
Coding Optimization
Before: Undercoded
After: Optimized
+12%
Annual Collections
Before: $620K
After: $715K
+15%
Hours Saved Weekly
Before: 0
After: 15 hrs
+15 h
Provider Take-Home
Before: Baseline
After: +$95K
+$95K
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