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Salt.
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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