Success story
Brookline Adult and Child Counseling (BACC)
BACC came to MedHeave with a high-risk revenue problem that it could not resolve internally.
Project Metadata
Specialty
Psychotherapy
City
Brookline, MA
Practice size
1 provider
Locations
Multi-location
The challenge
BACC came to MedHeave with a previous biller who was slow to respond, leaving communication gaps between the practice and its billing partner.
Accounts receivable aging in the 60 to 120+ day bucket had climbed to $40,111.24, with many claims left unpaid and unfollowed. Errors in patient charts were producing incorrect billing and payment issues, and payment adjustments were not being posted accurately.
The practice was unaware that it was out of network with UnitedHealthcare and Harvard Pilgrim, resulting in unexpected claim denials. Verification of benefits was handled inconsistently, and overall revenue was falling short of expectations.
Results
A/R aging reduced
$40,111.24 → $2,689.53 in the 60 to 120+ day bucket
Insurance revenue
Consistent growth since April, holding above $123 thousand monthly
Claim denials
Significantly reduced through corrected billing and submission processes
Credentialing initiated
Harvard Pilgrim in-network application submitted to prevent future out-of-network denials
What we did
Conducted a full revenue cycle analysis
Reviewed the practice’s billing and end to end revenue cycle processes to identify where claims and payments were breaking down.
Prioritized and reduced aging A/R
Aggressively worked the aging accounts, bringing the 60 to 120+ day bucket down from $40,111.24 to $2,689.53.
Standardized verification of benefits
Implemented daily VOB for all new patients, completed at least three days before their appointments, to catch eligibility and network issues before the visit.
Improved responsiveness and communication
Ensured every email and provider inquiry received a timely response, closing the communication gaps left by the previous biller.
Corrected automated invoicing errors
Identified that some patients were being charged incorrectly through automated invoicing. Disabled auto-invoicing and moved to manual invoicing to prevent unnecessary fees for both the provider and patients.
Strengthened claims submission accuracy
Tightened claim submission processes to ensure claims were billed accurately, significantly reducing denials.
Initiated Harvard Pilgrim credentialing
Submitted the facility’s Harvard Pilgrim in-network participation application to begin credentialing and help prevent future out-of-network claim issues.
Your patients need your attention.
Your claims need ours.
One conversation is enough to identify where your billing is losing revenue, which claims are failing and why, and what a correctly structured billing operation looks like for your practice type.
