The Practice
A four-provider Family Medicine practice in Central Florida with approximately 8,000 active patients across three locations. Mixed payer mix including commercial, Medicare, Medicaid, and a meaningful self-pay population.
The practice had run billing in-house with a two-person team for over a decade. Volume had grown faster than process maturity, and by the time they engaged Medviz, the team was triaging the most urgent claims and letting older A/R age into write-off territory.
The Challenge
Three problems compounded:
1. A creeping denial rate. Initial submissions were running at 18% denial rate — over five times the industry benchmark for Family Medicine. Most denials were preventable: missing modifiers, eligibility issues, and documentation gaps that should have been caught pre-submission.
2. Aging A/R the team couldn't catch up on. Over $200K in claims were aged 90+ days. The in-house team didn't have bandwidth to chase aged claims while still keeping up with new submissions.
3. No visibility into payer-specific patterns. The practice was being underpaid by two specific commercial payers but had no analytics to detect or appeal the underpayments.
The Engagement
Medviz proposed a phased transition: take over net new claims immediately while running a parallel Old A/R Recovery project on aged claims. The Services Agreement included Medical Billing & RCM, Denials Management, and Billing Audit as a 90-day initial scope.
Week 1. Discovery and onboarding. Medviz audited the EHR configuration, payer enrollments, and existing claim workflow. A dedicated practice-success manager was assigned. BAA executed.
Weeks 2–4. New claims went live with Medviz; Medviz's AI scrubbing caught and routed back four common denial patterns to the practice for clinical-documentation correction. Initial scrub-pass rate climbed from 82% to 94%.
Weeks 5–13. Old A/R recovery began in parallel. Medviz re-worked aged claims by payer category, prioritizing high-value denials and underpayments. Two payer-specific underpayment patterns were identified and appealed in bulk.
The Outcome
By the end of the first quarter:
Denial rate dropped from 18% to 2% — an 89% relative reduction. Of the 2% remaining, nearly all were appealed and overturned within 30 days.
Revenue lift of +27% on monthly collections compared to the trailing 12-month baseline.
$147K in previously written-off claims recovered through Old A/R Recovery, including $61K from a single underpayment pattern that had gone undetected for two years.
Days in A/R fell to under 30 — from a baseline of 67 days at engagement start.
The practice has since expanded the engagement to include Credentialing for new providers and onboarded Samaat.ai for clinical documentation across all four providers.
"Medviz transformed our billing process. Denials dropped, collections improved, and their team feels like an extension of our own. The Old A/R recovery alone paid for the first year of the engagement."