Improving Reimbursement For A Multi-Specialty Clinic

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Client

Multi-Specialty Clinic

Industry

Healthcare

Implementation

Medical Billing & Coding Outsourcing

Improving Reimbursement For A Multi-Specialty Clinic

The Business Problem

A fast-growing multi-specialty clinic was facing serious revenue cycle challenges. Reimbursements from insurance providers were consistently delayed, and the claim denial rate was alarmingly high. Improper medical coding and incomplete documentation led to rejections that required repeated follow-up, consuming time and resources.
Physicians were increasingly burdened with administrative responsibilities, including coding and reviewing documentation, which impacted patient care and overall clinic productivity. Additionally, the clinic lacked real-time visibility into the status of claims and denials, making it difficult for leadership to take timely corrective actions. This inefficiency negatively affected both cash flow and operational performance.

The Solution

ABIC stepped in to manage the clinic’s end-to-end medical billing and coding processes. A team of certified coders and billing specialists was deployed to ensure that all claims were accurately coded using the latest CPT and ICD-10 standards.
We conducted a thorough audit of the clinic’s existing claims and identified frequent coding errors and documentation gaps. Comprehensive staff training was provided to align clinical documentation practices with payer requirements.
ABIC also developed a secure, user-friendly portal that provided real-time access to claim statuses, denial reasons, and reimbursement timelines. Regular reporting dashboards were shared with clinic leadership, offering insights into denial trends, claim success rates, and overall financial performance. These reports supported timely interventions and process refinements.

The Outcome

Within the first quarter, claim denials decreased by 45%, and average reimbursement turnaround time improved by 30%. The administrative burden on physicians was significantly reduced, allowing them to focus more on patient care.

The clinic achieved 100% HIPAA compliance, improved its cash flow stability, and established a reliable system for revenue tracking. ABIC’s solution positioned the clinic for sustainable growth, enabling reinvestment into expanding services, hiring additional specialists, and improving patient outcomes.