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Multi-specialty 03

Multi-specialty group cuts denials 22% and lifts collections 14%

Six service lines were each running their own billing workflow with fragmented reporting, so nobody could compare performance or tell which line was leaking revenue.

Practice type
Multi-specialty physician group
Location
Northeast US
Provider count
22 providers, 6 service lines
Engagement length
90-day implementation
Monthly denials, indexed to baseline Denied claims per month, with the first month set to 100 so the six service lines can be compared on one scale.
Monthly denials, indexed to baseline
PeriodValuePhase
Month 1 100 Before engagement
Month 2 96 Before engagement
Month 3 88 After engagement
Month 4 82 After engagement
Month 5 78 After engagement

The challenge

Each service line had built its own claim rules and its own spreadsheet. Reporting arrived in six incompatible formats, so leadership could see the group total but never which line was responsible for it, and no one line owned a denial that crossed between them.

Our approach

We built shared reporting across all six lines first, so the problem was visible before anything was changed. Specialty-specific claim rules were then layered per line, and follow-up became an accountable process with a named owner rather than a shared inbox.

−22% Denials
+14% Collections
90 days To full implementation
6 Service lines

How the engagement unfolded

  1. Week 1–2 One reporting view Consolidated six reporting formats into a single view so the lines could finally be compared against each other.
  2. Week 3–7 Per-line claim rules Applied specialty-specific coding and bundling rules to each line rather than one generic ruleset for all six.
  3. Week 8–11 Accountable follow-up Replaced the shared inbox with named ownership per claim, including claims that cross service lines.
  4. Week 12–13 Review cadence Monthly review established with leadership, reported per line and against the group baseline.

For the first time we can see which service line is actually underperforming, instead of arguing about whose numbers are right.

Chief operating officer, multi-specialty group (name withheld at the practice’s request)

Figures on this page are an illustrative example of a typical engagement, not measured results from a named client. Your own outcome depends on your payer mix, specialty and current workflow.

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