Case Study
Case Study1
Pain Management Group — 6 Providers
From Denial Crisis to Financial Stabilization
Before Working With True Care Billing
This specialty group believed their collections were “healthy” at $300,000/month — but internal billing data revealed:
Financial Issue
- Denial rate at 18%
- $2,000,000 in aged A/R
- No denial pattern intelligence
- Staff overwhelmed with follow-ups
Measured Impact
- Nearly 1 in 5 visits went unpaid
- Revenue stuck beyond 60–120+ days
- High volume resubmissions, low recovery
- Time lost without revenue return
Denials weren’t just paperwork problems — they were cash flow roadblocks.
Diagnosis
Revenue leak was traced not to “billing speed” but to:
- Miscoded pain-specific procedures
- Missing modifier narratives
- Payer-specific frequency rules ignored
- Incomplete documentation at claim level
The issue wasn’t volume — it was precision.
True Care Billing Intervention
Action
- Coding overhaul
- A/R recovery
- Proactive denial defense
- Real-time dashboards
- Compliance tune-up
Strategy Applied
- Pain CPT + modifier pairing map created
- Aged bucket excavation by payer class
- Payer escalation + narrative corrections
- Weekly denial trend reporting
- Documentation & payer rule reinforcement
Results
KPI
Denials: 18% → 2%
Aged A/R recovered
Reimbursement speed
Staff burden
Improvement Achieved
85% denial reduction
$500,000 within months
3× faster
Follow-ups dropped by 70%
Outcome
Financial stability restored. Clinical focus regained.
Providers saw predictable cash flow instead of fluctuating collection cycles.
Testimonials
Case Study 2
Primary Care Solo Provider
A One-Provider Practice Nearly Doubled Monthly Collections
Before Working With True Care Billing
Issue
- Collections stuck at $20,000/month
- Denials at 25%
- Credentialing outdated
- Outdated coding rules
Financial Impact
- No growth despite full schedule
- 1 in 4 visits unreimbursed
- Several payers reimbursing incorrectly
- Frequent medical necessity pushbacks
This practice thought volume was the answer — but payer optimization was.
Diagnosis
Root cause was a mix of:
- Outdated coding specificity
- Absence of renewal-based rate negotiation
- Missing payer panel opportunities
- Recurring underpayment on high-frequency codes
True Care Billing Intervention
Action
- Coding modernization
- Denial reduction
- Credentialing expansion
- Contract renegotiation
- Dashboard setup
Execution
- Updated E/M + chronic care modifiers
- Pre-submission checks implemented
- Added 6 new payers
- Updated visit reimbursement rates
- Transparency on A/R + claims by payer
Results
KPI
$20,000 → $38,000/month
25% denials → <5%
A/R aged backlog cleared
Collections predictability
Improvement Achieved
+90% revenue lift
80%+ reduction
Within 60 days
Cash flow stabilized
Testimonial
Case Study 3
Mental Health & Telehealth Clinic — Multi-Payer Complexity
Before Working With True Care Billing
Issue
- Frequent telehealth coding rejections
- Modifiers not payer aligned
- Credentialing lag post-expansion
- Staff manually chasing claims
Impact
- 30–45 day payment lag
- Routines denied as “not covered”
- Newly added clinicians unpaid
- Burnout + backlog
Diagnosis
- Payer-specific telehealth modifiers ignored
- Improper time vs service code hierarchy
- Credentialing timeline didn't match scheduling expansion
True Care Billing Intervention
Action
- Telehealth coding matrix built
- Real-time denial forecast
- Credentialing acceleration
- A/R excavation
Mitigation
- By payer, by CPT, by frequency rule
- Pattern mapping by region
- No “schedule before enrollment”
- 4-month backlog cleared
Results
KPI
Denials: 22% → 3%
Telehealth reimbursement: +35%
A/R days: 50% reduction
Staff freed from claim follow-up
Measured Outcome
Founder Quote
Once True Care aligned coding with payer telehealth rules, our reimbursement stopped feeling like a guessing game.”
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