The Revenue Cycle Blog
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Preventing Last-Minute Coverage Issues Across 1,200 Cardiovascular Procedures
Coverage issues identified just before cardiovascular surgery can delay treatment and reimbursement. This case study shows how a procedure-specific eligibility verification workflow helped improve financial clearance across 1,200 cardiac procedures.
Case Study: Hidden Coding Risks Found in 13,980 Radiation Oncology Claims
Hidden coding errors in professional and technical component billing can delay reimbursement and increase audit risk. Discover how our Medical Coding & Audit Services reduced component-billing denials by 44% and protected approximately $465,000 in reimbursement opportunities.
Case Study: Resolving $865K in Unapplied and Underposted Payments for an ENT Practice
A multi-location ENT practice struggled with unapplied cash, payment posting errors, and reimbursement discrepancies despite strong claim acceptance rates. Learn how MBW RCM resolved $865,000 in unapplied and underposted payments through specialized payment posting workflows within 150 days.
Breaking a $1.2M Surgical Claims Backlog: How an ENT Practice Accelerated Cash Collections
See how a multi-location ENT practice recovered more than $1.2 million in aging surgical receivables through high-value claim prioritization, structured appeals, payer follow-up, and underpayment validation.
Case Study: Closing a $518K Revenue Gap in Spine Surgery Billing
Discover how MBW RCM helped a spine surgery practice close a $518K revenue gap in just 120 days. This case study highlights the billing strategies, coding improvements, and revenue cycle enhancements that strengthened reimbursement and accelerated collections.
A New York Spine Practice Reduced Underpayments by 42% Without Increasing Surgical Volume
A New York spine surgery practice was losing revenue through unnoticed contractual underpayments on complex fusion and instrumentation procedures. Learn how MBW RCM recovered $612,000, reduced underpayments by 42%, and increased net collections by 18% without increasing surgical volume.
Case Study: Increasing Charge Capture by 29% for a Freestanding Radiation Oncology Center
Despite timely claim submission and low denial rates, a freestanding radiation oncology center struggled with slower reimbursement growth. Discover how our Radiation Oncology Billing and Charge Capture Services increased charge capture by 29% and protected $418,000 in reimbursement through specialty-focused revenue integrity workflows.
Recovering $486K by Improving CABG and Valve Surgery Documentation Specificity
A hospital-affiliated cardiovascular surgery practice recovered $486,000 by improving CABG and valve surgery documentation through a specialty-focused Clinical Documentation Integrity (CDI) program.
Case Study: The Prior Authorization Mistake That Put $387,500 in Revenue at Risk
A Texas radiation oncology practice believed its prior authorization process was under control until our assessment uncovered workflow gaps that put $387,500 in reimbursement at risk. See how targeted improvements reduced denials and protected revenue.
Case Study: Reducing Radiation Oncology Claim Denials by 37%: A Real Client Success Story
A multi-location radiation oncology practice was facing rising claim denials despite timely submissions. Discover how specialty-focused billing strategies reduced denials by 37%, improved first-pass claim acceptance, and accelerated reimbursement for complex cancer treatment services.
The $226K Cash Reconciliation Problem Holding Back a Spine Practice
A multi-provider spine surgery practice in Arizona struggled with unapplied cash, delayed ERA reconciliation, and inaccurate payment posting. Learn how MBW RCM reconciled $226,000 in outstanding payments, reduced posting backlogs from 19 to 3 days, and improved financial reporting.
Turning Claim Submission Delays into 98% First-Pass Acceptance for an ENT Practice
A multi-location ENT practice improved its claim submission workflow, reduced clearinghouse rejections, and achieved a 98% first-pass claim acceptance rate through specialty-focused claim submission services.
How Outsourcing Urology Billing Increased Collections by 18% in Six Months
A Texas urology practice struggled with stagnant collections despite consistent patient volume. After outsourcing its billing operations, the practice improved claim accuracy, reduced denials, recovered $238,000 in missed revenue, and increased collections by 18% within six months.
What Was Causing 1 in 4 Cardiology Imaging Claims to Be Delayed?
A growing cardiology imaging program was performing more studies than ever, yet reimbursements continued to lag. This case study reveals how authorization mismatches, medical necessity reviews, and payer workflow bottlenecks caused nearly 25% of imaging claims to be delayed—and how targeted revenue cycle interventions helped recover over $500,000 while reducing payment delays by 64%.
Case Study: Increasing RAF Accuracy by 18% for HCC Coding Review
A Medicare Advantage provider with 25,000+ members improved RAF accuracy by 18% through retrospective HCC coding reviews, provider education, and ongoing coding audits. The initiative also increased HCC capture rates by 14% and reduced coding discrepancies by 35%.
Case Study: Reducing RADV Audit Risk Through Comprehensive HCC Coding Audits
A Medicare Advantage physician network facing significant RADV audit exposure improved HCC coding accuracy from 82% to 96% through comprehensive coding audits, provider education, and documentation improvements.
How We Recovered $180,000 in Aging Urology Claims Older Than 120 Days
A multi-provider urology practice was struggling with over $180,000 in outstanding claims aged beyond 120 days. Through focused denial resolution, payer follow-up, documentation recovery, and strategic A/R management, MBW RCM helped recover significant lost revenue, reduce aging balances, and improve cash flow within 120 days.
How a Hospital Identified $487,000 in Lost Revenue from General Surgery Billing
A detailed case study showing how a hospital improved collections, reduced denials, and recovered nearly half a million dollars through strategic general surgery billing improvements.
Fixing 38% Underpayment in Nerve Block & Epidural Claims in Pain Management Billing
A pain management practice faced a 38% underpayment rate in nerve block and epidural claims despite clean submissions. Through targeted billing corrections, we helped identify and fix reimbursement gaps to recover lost revenue and improve collections.
Case Study: Recovering $420K Annually from Claim Denials in ASC Billing
MBW RCM partnered with a Texas-based ASC facing a 24% claim denial rate and ongoing revenue loss. By addressing gaps in documentation, modifiers, and authorizations, we implemented a structured denial management approach. This reduced denials to 9% and delivered $420K in annual revenue recovery.