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What Was Causing 1 in 4 Cardiology Imaging Claims to Be Delayed?

A growing cardiology imaging program was performing more studies than ever, yet reimbursements continued to lag. This case study reveals how authorization mismatches, medical necessity reviews, and payer workflow bottlenecks caused nearly 25% of imaging claims to be delayed—and how targeted revenue cycle interventions helped recover over $500,000 while reducing payment delays by 64%.

Case Study: Increasing RAF Accuracy by 18% for HCC Coding Review

A Medicare Advantage provider with 25,000+ members improved RAF accuracy by 18% through retrospective HCC coding reviews, provider education, and ongoing coding audits. The initiative also increased HCC capture rates by 14% and reduced coding discrepancies by 35%.

Case Study: Preventing Oncology Denials with Smarter Coding Practices

An oncology practice was struggling with frequent medical necessity denials, missing documentation, and incorrect modifier use. By adopting smarter coding practices, targeted training, and pre-bill audits, denials were reduced by 75%, first-pass payments improved, and lost revenue was recovered.