Case Studies
Real Practices.
Real Numbers.
Every result below is from an actual client engagement — reported at 90 days post-onboarding. Practice names are withheld by request; specialty, size, and location are accurate.
Orthopedic Practice Cuts Denial Rate from 14.2% to 2.8% in 60 Days
The situation: A four-surgeon orthopedic group had been with the same billing company for 6 years. Their denial rate had crept to 14.2% — nearly double the specialty average. The primary causes were global period violations, missing modifier 59 on same-day procedure combinations, and prior auth lapses for arthroplasties. $340,000 was sitting in AR over 90 days.
"We had no idea we were leaving this much on the table. Within 30 days of switching to RCMAXIS, claims were going out cleaner than they ever had. The AR cleanup alone covered the first year of fees."
— Practice Administrator, Orthopedic Surgery Group, Dallas TX (name withheld by request)
Behavioral Health Group Recovers $412,000 in Missed Collections Over 12 Months
The situation: A large behavioral health group practice with psychiatrists, psychologists, and LCSWs was billing through a generic medical billing company with no behavioral health expertise. The practice was systematically misbilling MBHOs as medical benefits, under-coding E/M services by psychiatrists, and failing to bill add-on codes (90833) for combined medication management and psychotherapy visits. Estimated revenue leakage: $34,000/month.
"Our previous biller had no idea what an MBHO was. RCMAXIS fixed our routing within the first week. The difference in cash flow was visible by month two — we went from payroll anxiety to expansion planning."
— CEO, Behavioral Health Group Practice, Atlanta GA (name withheld by request)
GI Practice Adds $19,200/Month by Correctly Billing Screening-to-Diagnostic Colonoscopy Conversions
The situation: A 3-physician GI practice was billing all colonoscopy procedures with a single code regardless of findings. When a screening colonoscopy identified and removed polyps — converting the claim from screening to diagnostic — the practice was not applying the correct CPT code change, modifier PT, or -33 where applicable. This single error was systematically underbilling every polyp removal case.
"One coding error — one — was costing us $230,000 a year. RCMAXIS found it in the first week. We'd been with our previous biller for four years and they never flagged it once."
— Managing Physician, GI Practice, Chicago IL (name withheld by request)
Pain Management Practice Recovers $178,000 in Aged AR — Practice Had Written It Off
The situation: A 2-physician interventional pain practice switched to RCMAXIS after their previous biller stopped actively working claims older than 90 days — effectively writing off all aged AR as uncollectable. RCMAXIS inherited $178,000 in claims between 90 and 180 days old at transition. The previous biller had classified these as "write-offs." Most were still within timely filing windows for appeal.
"Our last biller told us that money was gone. RCMAXIS recovered $143,000 of it in 90 days. We didn't know you could do that. That recovery alone paid for two years of their fee."
— Office Manager, Pain Management Practice, Phoenix AZ (name withheld by request)
Your practice could be the next case study.
We offer a free, no-obligation revenue assessment for qualified practices. We'll audit your last 90 days of claims and show you exactly what you're leaving on the table — with numbers, not estimates.