Revenue Cycle Transformation Case Studies

An ophthalmology practice in New York faced major reimbursement issues when incorrect NPI/TIN setup caused in-network claims to process as out-of-network. MBW RCM identified the mismatch, corrected the provider configuration, and helped the practice prevent further revenue loss.

A New York ophthalmology practice faced repeated denials for refractions and diagnostic tests due to missing patient acknowledgments. MBW RCM implemented refraction policies, ABN procedures, and upfront collection workflows to prevent non-covered write-offs and protect revenue.

A South Dakota ophthalmology practice faced $151,695 in coding-related denials due to modifier errors, incorrect CPT/ICD pairings, and NDC discrepancies. MBW RCM corrected the coding issues, appealed denied claims, and helped the practice recover significant revenue.

An ABA therapy practice achieved a 41.6% increase in collections by optimizing its billing process, eliminating duplicate denials, and aligning with Tricare requirements. Learn how streamlined workflows and payer-specific compliance drove measurable financial gains.

See how we helped an Illinois oncology practice cut denials 15% and increase monthly collections by $11,800. Schedule your consultation today.

An oncology practice was struggling with frequent medical necessity denials, missing documentation, and incorrect modifier use. By adopting smarter coding practices, targeted training, and pre-bill audits, denials were reduced by 75%, first-pass payments improved, and lost revenue was recovered.

A gastroenterology clinic recovered 45% of lost revenue after fixing payment posting issues and streamlining its medical billing process.

A neurology clinic was losing revenue due to billing and denial issues. Learn how fixing coding errors and claim follow-ups led to a $389K recovery.

A mental health clinic had over $198K in missing revenue due to untracked payments and billing backlogs. Find out what went wrong—and how it was fixed.

A pediatric clinic reduced A/R days from 45 to 34 by addressing billing inefficiencies—this case study breaks down what changed and why it worked.

See how one plastic surgery clinic recovered $120K in missed revenue—learn what was wrong, what we fixed, and how fast the results followed.

Ohio OB practice cut ultrasound claim errors by 76% and boosted revenue by $33K/month through better documentation and provider education.

A Virginia-based healthcare group improved credentialing and reduced denials by tracking CAQH attestations—achieving 98% compliance and faster enrollments.

This case study highlights how billing OB GYN providers in Bozeman recovered $21,000 denied claims and reduce revenue loss. with MBW

See how MBW helped reduce general surgery medical billing denials by 76% and cut A/R days in half for a surgical group in Illinois.

Recovering NICU denial: Read how our neonatal billing experts helped a Texas practice fix denials & boost NICU claim approval rates by 42%.

See how Billings Clinic Emergency Department reduced claim denials by 64%, cut A/R in half and fixed coding issues with MBW's support.

Read how specialized ABA medical billing services helped a Phoenix clinic cut claim denials from 27% to 6% and reduce A/R days from 78 to 32.

What happens when a $32K surgery gets denied? This case study reveals how revenue was brought back fast—with Denial Management Service.

Explore real-world case studies showcasing how we improve HCC Coding and billing efficiency and revenue for healthcare providers.

Read how we recovered $200K in underpayments for an Atlanta radiology practice, restoring lost revenue and improving cash flow.

Read a Case Reports in Cardiology billing on how we achieved a 15% drop in claim denials and a 67% boost in appeal resolution.

Read our case study detailing how we fixed patient registration delays in the Emergency Department for optimal patient satisfaction.

Our client, a mid-sized hospital group, faced challenges getting reimbursed for ED visits. Sub-optimal client documentation processes led to delayed payments and reduced reimbursements. Our initial analysis revealed that delayed billing was the root cause. We conducted an exhaustive internal audit of 30 physicians working across two facilities in Washington and Florida. In this case study, we highlight how improved clinical documentation and coding quality lead to increased reimbursements.

Our client, an IOWA-based anesthesia practice operating from 3 locations with 12 anesthesiologists in the group, was facing increased denials due to preventable causes. Anesthesia procedures are unique and require specific diagnosis codes. Hence, the quality of documentation by the Anesthesiologists plays a critical role in reducing coding-related denials. In this case study, we share the best practices applied by our team while billing & coding for Anesthesia practice.

Our client, a Maryland-based Medical Billing & Coding Company, was challenged with billing & coding for all vaccinations done at an urgent care clinic in North Carolina. The urgent care center had partnered with the North Carolina Department of Health & Human Services, thereby conduction the majority of the Vaccination drives at their care centers. In this case study, we share the best practices applied by our team while billing & coding for COVID-19 vaccination.

Amidst the uncertainties of the pandemic, our client, a healthcare provider in Central Florida, had launched Covid-19 testing for both insurers and non-insured patients. Although the client got reimbursed successfully for the insured patients' claims, they were looking for a third-party RCM management company like MBW to help them submit claims electronically under the HRSA program. In this case study, read more about how our team helped collect $60k with a first-pass claim submission rate for Covid testing under the HRSA program.

Invalid Diagnosis codes can cause coding errors and inflate claim denial rates. Often, healthcare providers tend to utilize superbills and mark the nearest available codes on the superbills. One of our clients, a podiatry provider, used superbills. The providers habitually marked the 99309 procedure on the superbill and notified the billing team for processing. However, as per Medicare and Medicaid regulations, 99309 and 99252 need to be entered for the claims to get reimbursements. Due to the lack of a clear understanding of the coding guidelines, the providers marked invalid diagnosis codes on the superbill.

Understanding California, Payer, and Behavioral health-specific nuances and diligent focus on enrollment, timely filing, and payments reconciliations reduced denial rates and increased collections by 52%.

Many Primary Care Physicians lose money because of lack of understanding of payer specific claims submission guidelines. Educating physicians on their documentation responsibilities is an iterative process, that requires an understanding of the reasons for claim denials, ability to nail-down the issues that are causing the denials, determining the corrective actions, and hosting timely sessions between the denials team and the physicians to discuss them.