A mid-sized Allergy and ENT practice with multiple providers was struggling to keep up with billing operations. Their in-house staff was overwhelmed by insurance requirements, resulting in delayed payments and rising denials.
• High denial rate (22%) due to coding errors and missing authorizations
• AR days averaging 65 days, leading to cash flow issues
• Frequent delays in eligibility verification and prior authorizations
• Inaccurate charge entry, resulting in lost revenue
CMSPROBILLING implemented a customized revenue cycle management strategy tailored to Allergy & ENT services:
• Performed real-time eligibility verification before patient visits
• Streamlined prior authorization process for allergy testing and procedures
• Improved coding accuracy through clinical documentation review
• Optimized charge entry and claims submission to reduce errors
• Assigned a dedicated team for AR follow-up and denial management
• Ensured timely payment posting and reporting for full transparency
Within 6 months of partnering with CMSPROBILLING, the practice achieved:
• Denial rate reduced from 22% to 6%
• AR days improved from 65 to 28 days
• Revenue collections increased by 18%
• Clean claim rate reached 97%
• Significantly reduced administrative burden on providers and staff