Success story
William Pullano MD
William Pullano MD came to MedHeave with a high-risk revenue problem that it could not resolve internally.
Project Metadata
Specialty
GastroenterologyÂ
City
New York, NY
Practice size
1 provider
Locations
Single location
Payer
Mixed payer (Commercial + Medicare)
The challenge
A solo gastroenterology practice in New York came to MedHeave with approximately $48,000 stuck in accounts receivable and a monthly collection rate that had deteriorated to just $5,000–$6,000, down from a prior average of $15,000.
Because Dr. Pullano was out-of-network with most commercial payers, prior authorizations were mandatory for nearly every claim. The previous billing vendor had no dedicated process for managing this, leaving authorizations untracked and claims routinely denied.Â
Compounding the problem, claims were being submitted to the wrong payers due to unverified eligibility, creating a growing backlog of misdirected claims aging beyond 90 days. The practice was losing revenue every month with no clear path to recovery.
Results
$8 Thousand first month under MedHeave
Month 1 collections
$51 Thousand, 6x increase in 30 days
Month 2 collections
$35–40 Thousand sustained after 1 year
Steady-state monthly avg
60–90 days full operational control achieved
Time to results
Minimal, previously denied claims recovered
Ongoing AR aging
What we did
Assigned a dedicated out-of-network authorization specialist
Centralized all prior authorization work under a specialist with deep expertise in out-of-network commercial payer requirements. Authorizations were no longer treated as a routine task; every case was tracked, followed up on, and confirmed before claims were submitted.
Implemented daily eligibility verification
Introduced daily insurance eligibility checks for all patients and shared eligibility reports with the provider each morning. This eliminated the root cause of misdirected claims and prevented eligibility-related denials from recurring.
Conducted full coding review & corrected payer submissions
Performed a comprehensive review of medical records to address coding accuracy across all claim types. Identified and corrected claims submitted to the wrong payers, reprocessed and resubmitted them to the correct carriers, and recovered the aging AR balance that had accumulated under the previous setup.
Rebuilt collections stability through denial prevention
Rather than reacting to denials after the fact, establish proactive workflows across eligibility, authorization, and coding to prevent denials at the source. Within a year, monthly collections stabilized at $35,000–$40,000, more than double the practice’s prior best average, with minimal ongoing aging.
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.
