$180K in unrecovered revenue found in one quarter
Anonymization note: Client requested anonymity while completing a transition between revenue cycle management vendors.
Collections seemed normal. Nobody was reconciling.
A 92% clean claims rate. Denial rates "within industry norms." Monthly reports from a billing company the clinic had trusted for years. By every metric the owner had access to, the revenue cycle was healthy.
The problem: nobody was reconciling billing data with bank deposits. The billing company reported what they submitted. Nobody tracked what actually got paid, what got denied and stayed denied, or what slipped past timely filing deadlines.
The owner trusted the reports. The reports were accurate — they just did not tell the whole story.
$180K gone in a single quarter
Denials sitting untouched for 45+ days on average
By the time anyone looked, many had aged past appeal windows — 70% were written off without a single appeal attempt
Claims past timely filing limits with no recovery possible
Tens of thousands permanently lost in the quarter reviewed
Underpayments accepted without appeal
Tens of thousands paid below contracted rates and never flagged
No billing-to-bank reconciliation process
Discrepancies between billed, paid, and deposited amounts went undetected
Reconciliation, accountability, and payer contract audits
The billing company was doing its job. Submitting claims. But submission is step one. Nobody owned step two: following up on denials, appealing underpayments, and reconciling what was billed in WebPT against what actually hit the bank account.
We built the systems that closed this gap.
Set up billing-to-bank deposit reconciliation process
Implemented denial management workflow with aging accountability in Prompt
Audited payer contracts against actual WebPT reimbursement data
Established monthly revenue cycle review meetings
Created dashboard tracking submission-to-payment lifecycle
Majority of leaked revenue recovered within 2 quarters
Revenue recovered
$0 (losses undetected)
Majority of the $180K recovered
Ongoing collections rate
88%
94%
Days to first follow-up after denial
45+ days
5 days
Billing-to-bank reconciliation
None
Monthly
The short version
Your billing company submits claims. Who follows up when they get denied? If nobody is reconciling billing data with bank deposits, you do not know what you are actually collecting — you only know what was billed.
Methodology
Methodology: Recovered revenue is the increase in collections against expected collectible revenue — charges less contractual adjustments — attributable to fixes identified and implemented during the engagement. It is not gross charges minus collections, which would count normal contractual adjustments as losses. Measured over the window stated in the case. These are anonymized engagement narratives: identifying details are altered, and figures are reported outcomes rather than predictions.
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