Success story
Partners in Rehabilitation
Partners in Rehabilitation came to MedHeave with a high-risk revenue problem that it could not resolve internally.
Project Metadata
Specialty
City
Saugus, Georgetown, Methuen, and Wilmington, MA
Practice size
4 providers
Locations
Multi-location (4 locations)
The challenge
Partners in Rehabilitation came to MedHeave with a revenue cycle that was slowing cash flow at four locations. Roughly 60% of claims were being denied or rejected, which delayed payments and created constant rework. The A/R was not being worked consistently, and a backlog of unposted claims and payments had left a large, aging balance outstanding.
Benefit verification was also producing inaccurate patient responsibility amounts. Some VOBs showed a $10 copay while the EOB reflected $50 in patient responsibility. Others showed a $40 copay where the EOB showed the service fully covered, or showed full coverage where the EOB later assigned patient responsibility. Patient balances were affected as a result.
During our review, we also found problems with coding, modifiers, and units billed that were causing avoidable rejections and denials. The volume of denials and billing discrepancies also raised the practice’s exposure to payer scrutiny. There was no confirmed payer action, but leaving the issues unresolved could have led to payer reviews or further payment delays.
The practice’s earlier setup lacked a structured process for tracking denials, A/R aging, unposted claims, and payer-specific issues. Problems stayed open or kept recurring, and nobody was tracing them to a root cause.
Results
Denial & rejection rate
Reduced from ~60% to ~5%
A/R days
Reduced from 50–55 to 35–40
Collections
Increased from ~$100K to around $135K, with a high of almost $167K in May 2026
Time to first results
2 months
Results sustainability
Ongoing: A/R follow-up, denial tracking, and VOB-to-EOB reporting are now part of the standing process
What we did
Worked the A/R by payer, starting with the highest balances
We pulled the complete aging report and prioritized high-balance and aging claims. Each payer’s outstanding claims, payment issues, and follow-up requirements were then worked in order.
Set up payer portal access and cleared the unposted backlog
We established access to the insurance portals needed for claim follow-up and payment tracking. We then reconciled and posted the previously unposted claims and payments, so the A/R reflected what was actually outstanding.
Traced denials to their cause
We did not simply resubmit denied claims. We reviewed what was behind the denials and rejections, including missed billing, coding, modifiers, and units billed. We corrected those errors and added claim review steps to keep them from recurring. This is how the denial and rejection rate went from ~60% to ~5%.
Identified and reported VOB-to-EOB discrepancies
During payment posting, we track and separate every case where the verified benefits did not match what the payer processed. The affected patient balances are escalated, and the findings are reported back to the practice. This lets the practice see recurring patterns and strengthen its own verification and documentation process.
Put structured A/R follow-up in place
A/R is now worked on a consistent schedule, with denial and rejection trends tracked over time. This gives the practice visibility into aging receivables and the status of open claims.
