Key takeaways
- An Ohio behavioral health practice started with us in 2024 with three providers: an LPCC, a PMHNP and an LMFT.
- It now has 18 providers across 5 service locations.
- The monthly patient caseload grew from 300+ to more than 900.
- Monthly collections grew from about $25,000 at signing to $98,000 last month.
- We manage the practice’s complete revenue cycle: verification of benefits, claims creation and submission, rejections and denials, EOB posting, and both insurance AR and patient AR.
- Collections grew as the practice added providers and locations. Results vary by practice and payer.
The situation
An Ohio behavioral health practice signed with us in 2024. At the time it had three providers, an LPCC, a PMHNP and an LMFT, one location, a monthly caseload of just over 300 patients, and monthly collections of about $25,000. As the practice added clinicians and locations, the billing work had to scale with it: more payers, more claims, and more moving parts between a session and a posted payment.
The practice is anonymized here, and no patient, provider or payer-specific details are shared.
What we manage
We run the practice’s complete RCM, agreed in writing. In general terms, that covers:
- Verification of benefits (VOB) before treatment begins
- Claims creation, scrubbing and submission
- Rejection and denial follow-up, with causes tracked
- EOB and ERA posting and reconciliation
- Insurance AR follow-up
- Patient AR and statements
The result
| Measure | At signing (2024) | Now |
|---|---|---|
| Providers | 3 | 18 |
| Service locations | 1 | 5 |
| Monthly patient caseload | 300+ | 900+ |
| Monthly collections | About $25,000 | $98,000 last month |
Collections grew almost four times while the caseload roughly tripled and the roster grew from three providers to eighteen. Growth like this only converts into collections when every new provider is enrolled, every new location is set up with each payer, and the daily billing work keeps pace, which is exactly the part the practice handed to us.
What this shows
In behavioral health, the billing complexity grows faster than the practice. Three providers with one payer mix is manageable in-house. Eighteen providers across five locations, each with their own credential type and payer panel, is a different job. A practice that wants to grow that way needs VOB, claims, denials and AR handled as one connected workflow, not as separate tasks that each new hire makes heavier.
Frequently asked questions
What does complete RCM include here?
Verification of benefits, claims creation and submission, rejection and denial work, EOB posting, insurance AR and patient AR. The scope of every engagement is agreed in writing before work begins.
Did billing alone cause the growth?
No. The practice’s own growth in providers, locations and caseload drove the volume. Our job was to make sure that growth turned into clean claims and collected revenue. Results vary by practice and payer.
Can you take over mid-growth?
Yes. We review the provider, location and payer setup first, then agree a transition plan so claims keep going out while workflows move over.
Growing faster than your billing can keep up?
We can review your billing workflow and payer setup before the backlog builds.
The initial audit is complimentary.
Related reading: Case Study: Managing Billing and RCM for a Growing Behavioral Health Practice · Behavioral Health Billing: Common Denial Causes and How to Fix Them
About the author
Kamran Muzaffar is the founder of MedWork Services and has 12 years of experience in healthcare revenue operations. He oversees the Billing, Credentialing and Licensing departments and works directly with providers on enrollment and revenue recovery.
General information only. Payer rules and regulations change, so confirm current requirements for your situation.