Results & case studies
Real outcomes for real health systems.
Every engagement is different. The results speak for themselves.
Performance across our client portfolio
Aggregated outcomes from health system engagements over the past five years.
Revenue recovered
Total reimbursements recovered across all active client engagements
First-pass claim rate
Claims accepted and processed without correction on first submission
Average denial reduction
Reduction in denial rates achieved within the first 90 days of engagement
AR days improvement
Average reduction in days in accounts receivable within the first quarter
Case studies
Client outcomes in detail
Background
A mid-Atlantic regional health system with six facilities was experiencing a 19% denial rate — nearly double the industry benchmark — driven by front-end eligibility gaps and inconsistent coding across service lines.
The challenge
The system had worked with two prior RCM vendors without meaningful improvement. Denials were concentrated in their highest-volume payers, and the internal team lacked the bandwidth to manage appeals alongside day-to-day billing operations.
Our approach
Physician First RCM deployed a dedicated denial management team within two weeks of contract execution. We conducted a full denial root-cause analysis, identified the top five denial drivers by payer and reason code, and implemented targeted upstream fixes — including real-time eligibility checks at registration and a coder education program for the three highest-denial service lines.
Results
Reduction in denial rate
within 90 days
Revenue recovered from aged denials
in first 6 months
Denial rate at 12 months
down from 19% at engagement start
"We'd been told our denial rate was a coding problem. Physician First showed us it was actually a registration problem — and fixed it in weeks, not quarters."
— VP of Revenue Cycle, Regional Health System
Background
A 900-bed academic medical center with a complex payer mix — including significant Medicaid managed care and out-of-state commercial volume — was averaging 58 days in accounts receivable, well above their internal target of 35 days.
The challenge
The organization had strong clinical documentation but inconsistent follow-up on outstanding claims. Payer-specific escalation paths were not documented, and the billing team was spending disproportionate time on low-balance accounts while high-value claims aged.
Our approach
We restructured their AR work queues by payer, balance tier, and age — ensuring high-value claims received priority follow-up. We documented escalation paths for their 12 highest-volume payers and implemented a weekly AR aging review with their revenue cycle leadership.
Results
Average AR cycle at 6 months
down from 58 days
Recovered from accounts over 120 days
in first 90 days
Reduction in accounts over 90 days
within 6 months
"The AR improvement was faster than anything we'd seen internally. More importantly, the process changes they put in place have held up — we haven't regressed."
— CFO, Academic Medical Center
Background
A 220-physician multi-specialty group had undergone a CMS risk adjustment audit and received findings indicating systematic undercoding in their primary care and cardiology service lines. HCC capture rates were significantly below benchmark.
The challenge
The group's existing coding team was experienced in fee-for-service coding but had limited HCC risk adjustment expertise. The audit findings created both a compliance obligation and a revenue recovery opportunity.
Our approach
Physician First RCM deployed a team of CRC-credentialed coders to conduct a retrospective HCC review across two years of primary care and cardiology encounters. We identified documentation gaps, provided targeted CDI education to the clinical staff, and implemented a prospective HCC capture program going forward.
Results
HCC revenue recovered retrospectively
across 24 months of encounters
Coding accuracy rate post-engagement
verified by independent audit
Improvement in HCC capture rate
in first prospective year
"The retrospective review alone paid for the engagement many times over. The prospective program they set up has become a permanent part of how we operate."
— Chief Medical Officer, Multi-Specialty Physician Group
By the numbers
Consistent performance across every engagement
Health systems served
Hospitals and multi-site health systems across the country
Years in operation
Founded in 2014, growing through referrals for the first five years
Client retention rate
Clients who renew their engagement after the first contract term
Average time to go-live
From contract execution to full operational handoff
HIPAA audit pass rate
Across all third-party compliance audits since founding
Annual claims volume managed
Total claims value processed across our active client base each year
See what these results could look like for your organization.
Schedule a revenue cycle assessment and we'll benchmark your current performance against our client portfolio.
Request a Free Assessment