Health & wellness · 🇺🇸 United States
Billing insurers and never chasing the denials
A practice writing off denied claims without review was losing a meaningful share of billed revenue silently.
US chiropractic practice, insurance and cash patients. Client identity withheld — we publish names only with written permission, so this engagement is described by its shape rather than by who it was.
19%
Of claims initially denied
$47k
Recovered on resubmission
Weekly
Denial review introduced
The situation
- The practice billed insurers and recorded revenue on payment received.
- Denied claims were written off without anyone reviewing why.
What we found
- About 19% of claims were denied on first submission, a substantial share for correctable coding reasons.
- Because revenue was recorded on receipt, denials were invisible in the accounts — the loss never appeared anywhere.
- Cash-pay patient revenue was not separated from insurance revenue, hiding the payer mix.
What we did
- Recorded billed revenue and receivable separately from cash received, so denials became visible.
- Introduced a weekly denial review with resubmission for correctable causes.
- Separated cash-pay from insurance revenue to make payer mix visible.
The outcome
- Roughly $47,000 was recovered on resubmission in the first year, and denial rate fell as coding causes were fixed.
- Seeing payer mix changed which services the practice promoted.
What we'd flag
Recording billed revenue rather than cash received made the accounts look worse initially — receivables that had always existed simply became visible.
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