Case Studies

Real results from real practices. Every case study represents actual performance improvements achieved by Go Medical Billing clients. Names and identifying details have been changed to protect client confidentiality.

AAPC Certified
HIPAA Compliant
All 50 States
Starting at 2.49%
$540K+
Combined Revenue Increase
70%
Avg Denial Reduction
50%
Avg A/R Days Reduction
96%+
Target Net Collection Rate
CardiologySoutheast US|6 Cardiologists, 3 NPs

Cardiology Group Recovers $340K in Annual Revenue

!The Challenge

A 6-provider cardiology group was experiencing a 16.2% initial claim denial rate, A/R days averaging 62, and a growing backlog of unworked claims over 90 days. Their in-house billing team of 3 was overwhelmed by the volume and complexity of interventional cardiology coding. Cardiac catheterization bundling errors, missing modifiers on multi-vessel PCI claims, and inconsistent prior authorization tracking were causing preventable denials on high-dollar procedures worth $2,000 to $15,000 each.

Our Solution

Deployed AAPC-certified cardiology coders who specialize in cath lab, echo, and interventional coding with proper modifier usage
Implemented a denial prevention workflow that scrubs every claim against payer-specific CCI edits before submission
Built a prior authorization tracking system for all interventional procedures with automated status follow-up
Conducted a detailed chart audit of 200 recent encounters, identifying systematic undercoding of echo studies and missed chronic care management (CCM) opportunities
Took over 847 claims in the 60-120 day aging bucket and began systematic recovery

The Results

Metric
Before
After
Change
Initial Denial Rate
16.2%
4.8%
-70%
Days in A/R
62 days
31 days
-50%
Annual Collections
$3.2M
$3.54M
+$340K
Clean Claim Rate
82%
97.6%
+19%

Results measured over first 12 months

Key Actions & Outcomes

Recovered $87,000 from legacy A/R claims in the first 90 days
Identified $42,000 in annual underpayments from a single payer's incorrect fee schedule
Added $55,000 in annual CCM revenue from Medicare patients already being managed
Reduced authorization-related denials from 23 per month to 2 per month
We didn't realize how much revenue was falling through the cracks until Go Medical Billing showed us the data. The cath lab coding alone was costing us six figures a year in preventable denials. Within 90 days, the difference was obvious in our bank account.
Dr. M.R.
Managing Partner, Cardiology Associates
Urgent CareMidwest US|4 Locations, 12 Providers

Urgent Care Network Eliminates 45-Day Billing Backlog

!The Challenge

A 4-location urgent care network was drowning in billing backlogs. Their in-house biller had resigned, and a temp staffing solution was submitting claims 30 to 45 days after the date of service. With 60+ patients per day per location, thousands of claims were piling up. Timely filing denials were mounting. E/M coding was inconsistent across locations, with some providers defaulting to level 3 (99213) for 80% of visits regardless of complexity. Ancillary services (rapid tests, X-rays, nebulizer treatments) were frequently performed but not captured on the charge ticket.

Our Solution

Onboarded all 4 locations within 2 weeks, including EHR integration with their eClinicalWorks system
Eliminated the 45-day backlog within the first 30 days by processing 3,200 aged claims
Implemented same-day claim submission — encounters are coded and submitted within 24 hours of the date of service
Conducted E/M coding education sessions with providers, demonstrating that 2021 MDM guidelines support higher levels for many urgent care visits
Built a charge capture audit process that cross-references orders placed in the EHR against charges billed

The Results

Metric
Before
After
Change
Claim Submission Lag
30-45 days
< 24 hours
-98%
Average E/M Level
3.12
3.58
+15%
Revenue Per Visit
$142
$187
+32%
Monthly Collections
$320K
$448K
+$128K/mo

Results measured over first 6 months

Key Actions & Outcomes

Prevented $48,000 in timely filing denials by clearing the backlog before deadlines expired
Identified 12% of ancillary services were performed but never billed — recovered $8,400/month in missed charges
Upgraded 22% of E/M codes from level 3 to level 4 where documentation supported it
Saved the practice $156,000/year in billing staff salaries and benefits by outsourcing
When our biller quit, we panicked. Go Medical Billing took over all 4 locations in two weeks and cleared the backlog in a month. But the real surprise was how much revenue we'd been leaving on the table with undercoding and missed charges. Our collections jumped 40% and we didn't see a single additional patient to get there.
Dr. S.P.
Medical Director, Midwest Urgent Care

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Internal MedicineNortheast US|3 Internists, 2 NPs

Internal Medicine Practice Adds $180K with Care Management Codes

!The Challenge

A 5-provider internal medicine practice had stable collections but suspected they were leaving money on the table. Their denial rate was acceptable at 8%, but A/R days had crept to 48 and their net collection rate was only 91% — below the 95%+ benchmark. More critically, the practice was not billing any care management codes (CCM, TCM, AWV add-ons) despite managing a predominantly Medicare patient panel with multiple chronic conditions. The G2211 visit complexity add-on code, available since January 2024, was not being billed at all.

Our Solution

Implemented chronic care management (CCM) billing program for eligible Medicare patients — identified 280 patients with 2+ chronic conditions
Launched transitional care management (TCM) capture for patients discharged from hospital — coordinated with local hospital's discharge notification system
Added G2211 (visit complexity add-on) to all qualifying established patient E/M visits
Optimized E/M coding using 2021 MDM guidelines — documentation reviews showed 35% of visits could support a higher E/M level
Implemented systematic underpayment identification, comparing every payment against contracted rates

The Results

Metric
Before
After
Change
Net Collection Rate
91%
96.8%
+6.4%
Days in A/R
48 days
33 days
-31%
Annual Revenue Increase
+$180K
New Revenue
Care Management Revenue
$0
$112K/yr
From Zero

Results measured over first 12 months

Key Actions & Outcomes

Enrolled 180 Medicare patients in CCM program generating $7,560/month in recurring revenue
Captured 45 TCM opportunities in the first year at $170-$250 each ($9,000+ recovered)
Added G2211 to 4,200 established patient visits ($16 each = $67,200 annual)
Identified and recovered $23,000 in underpayments from 3 commercial payers with incorrect fee schedules
I had no idea we qualified for chronic care management billing. We were already doing the work — calling patients, refilling medications, coordinating referrals — but we weren't capturing any of that revenue. Go Medical Billing set up the CCM program, added the G2211 code we'd been missing, and found underpayments we never would have caught. An extra $180,000 in the first year without seeing a single additional patient.
Dr. A.K.
Physician Owner, Internal Medicine Associates

Our Methodology

All case study metrics represent actual client performance improvements. “Before” metrics are measured from the 3-month period prior to Go Medical Billing engagement. “After” metrics are measured at the timeframe specified in each study. Client names and identifying details are anonymized to protect confidentiality. Individual results vary based on practice size, specialty, payer mix, and baseline performance.

We Serve 40+ Medical Specialties

These case studies represent a fraction of the specialties and practice types we work with.

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