Introduction
A well-established radiology practice in Atlanta, Georgia, was facing a considerable revenue shortfall due to underpayments from insurers. Over a span of several months, underpayments had accumulated to an alarming $200,000. This issue severely impacted the practice’s revenue stream, and the staff struggled to resolve it seamlessly.
In July 2024, Medical Billing Wholesalers stepped in to help. Through our Underpayment Recovery Services, we successfully identified and recovered the $200,000 in underpayments within just three months, restoring the practice’s economic stability.
Client Overview
The practice specializes in diagnostic imaging and radiology services, serving a broad patient base in the Atlanta area.
Location: Atlanta, Georgia, US
Our Service: Radiology Billing Services
Monthly Patient Volume: 350
Monthly Revenue Cycle Volume: $400,000
Average Monthly Collections: $220,000
Challenges
The practice was facing several key challenges that led to the ongoing underpayment issue:
Frequent Underpayments: Insurance companies often paid less than what was billed, leaving extensive gaps in expected revenue.
Lack of Payment Transparency: Insurers failed to provide clear explanations for the underpayments, leaving the practice unsure about the reasons behind the errors.
Manual Tracking System: The practice relied on outdated manual systems to track payments, which made it hard to spot underpayments quickly.
Delayed Claims Reconciliation: The process of reconciling insurance payments with claims was slow, leading to unresolved underpayments.
Increased Administrative Workload: The staff spent considerable time on manual follow-ups with insurers, diverting attention from other important tasks.
These issues were not only impacting operating funds but also placing a considerable burden on the administrative team.
Our Approach
To address these issues, Medical Billing Wholesalers implemented a multi-pronged approach to systematize payment recovery, improve tracking, and ensure timely communication with insurers.
Analysis
By implementing this strategy, we were able to identify and address the root causes of the practice’s underpayment issues. Below is a breakdown of how our approach addressed each specific challenge:
| Challenge | Solution Implemented |
| Frequent Underpayments | Conducted a detailed audit to identify all underpayments and worked with insurers to recover the differences. |
| Lack of Transparency | Provided clear reports to the practice, outlining each underpayment and the steps required for resolution. |
| Inefficient Payment Tracking | Introduced an automated system to track payments and flag differences as soon as they arose, improving effectiveness. |
| Slow Claims Reconciliation | Optimized the reconciliation process, reducing the time taken to match payments with claims by over 40%. |
| High Administrative Burden | Automated follow-ups and reporting, freeing up staff time for more critical tasks and reducing manual workload. |
Each solution addressed a key area of the practice’s workflow, eliminating operational challenges, and ensuring faster payment recovery. If your practice is facing similar underpayment issues, let us help you recover missed revenue. Learn more about how our Underpayment Recovery Services can support your practice’s profitability.
Results
- Underpayments totalling $200,000 were fully recovered in just three months, restoring the practice’s Revenue flow and stabilizing revenue.
- Claims reconciliation time was cut by 40%, enabling the practice to identify and resolve payment inconsistencies more quickly.
- Payment accuracy improved to 95%, extensively reducing the chances of future underpayments.
- Automation decreased manual follow-up time by 60%, allowing administrative staff to focus on more critical tasks.
- Direct communication with insurers improved response times, leading to rapid resolutions and stronger working relationships.
Conclusion
With the help of Medical Billing Wholesalers’ Service, the radiology practice in Atlanta successfully recovered $200,000 in underpayments in just three months. The practice now enjoys a more efficient revenue cycle, better payment accuracy, and a refined process for managing insurance claims.
If your practice is experiencing underpayment issues or struggling with payment inconsistencies, we are here to help and support your revenue cycle also increase your bottom line.
