Success story
Tender Medical Care
Tender Medical Care came to MedHeave with a high-risk revenue problem that it could not resolve internally.
Project Metadata
Specialty
Internal Medicine
City
New York, NY
Practice size
1 Provider
Locations
Single location
Payer
Mixed payer
The challenge
A solo internal medicine practice in New York was losing revenue silently, not from obvious denials, but from a broken software integration. The practice relied on an EHR and a billing EMR connected via API, but the link was failing without anyone noticing.Â
Approximately 600 claims were never pulled into the billing system and went unbilled entirely. On top of that, claims were being submitted with 16–18 CPT codes when most payers would only reimburse 6–7, causing routine underpayments and denials.
Â
Poor reporting visibility meant the provider had no clear picture of what was stuck in AR. Patients were receiving incorrect bills, generating disputes and eroding trust. The previous billing vendor had never flagged any of these failures.
Results
$140 Thousand up
Monthly revenue — after
from $85 Thousand under the previous vendor
40–60% sustained monthly increase
Revenue growth
75% of 600 stuck claims processed
Claim backlog recovered
$120 Thousand+
Stable monthly collections
consistently maintained post-recovery
90 days backlog resolved, billing normalized
Time to major results
Eliminated CPT coding aligned to payer limits
Coding errors
What we did
Diagnosed & resolved the EHR/EMR integration failure
Identified that the API connection between the EHR and billing EMR was silently dropping claims. Categorized all 600 affected claims by status and urgency, implemented temporary manual workflows to clear the most critical cases, and ultimately facilitated a full billing software transition to eliminate the integration gap permanently.
Fixed CPT coding to match payer reimbursement limits
Corrected claims that were being submitted with 16–18 CPT codes, far exceeding what payers would process. Established coding guidelines aligned to payer-specific limits of 6–7 codes, eliminating a systematic source of denials and underpayments across all claims.
Rebuilt reporting & AR visibility
Overhauled the reporting setup so that billing, AR aging, denials, and payments could be monitored weekly with accurate data. This gave the provider clear visibility into practice finances for the first time and enabled data-driven decisions rather than guesswork.
Corrected patient balances & implemented proactive VOB
Placed a temporary hold on new patient charge posting until eligibility and pricing were verified, preventing further billing errors. Introduced proactive verification of benefits checks so patient responsibility was accurate before bills were sent, drastically reducing patient disputes.
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.
