Practice type: Interventional pain management Providers: 1 pain management physician, 1 CRNA Location: United States Monthly claim volume: Approximately 650 claims per month Situation at engagement: Payment posting managed in-house with no contracted rate reconciliation Discovery method: Free billing audit initiated by the practice owner Timeline: 6 months from audit
Practice type: Solo nurse practitioner practice Provider: 1 family nurse practitioner (FNP-C) Location: United States Patient volume: Approximately 380 patient encounters per month Payer mix: 44% Medicare, 33% commercial (BCBS, Aetna, UHC), 15% Medicare Advantage, 8% Medicaid Services: Primary care office visits, preventive care, Annual Wellness Visits, chronic disease management,
Practice type: Outpatient physical therapy group Providers: 2 physical therapists, 1 physical therapist assistant Location: United States Patient volume: Approximately 1,100 patient encounters per month Payer mix: 36% Medicare, 41% commercial (BCBS, Aetna, Cigna, UHC), 14% Medicare Advantage, 9% workers’ compensation Services: Orthopedic rehabilitation, post-surgical rehab, sports medicine, neurological rehabilitation,
Practice type: Solo outpatient psychology practice Provider: 1 licensed psychologist (PhD) Location: United States Patient volume: Approximately 120 patient encounters per month Payer mix: 41% commercial (BCBS, Aetna, UHC), 28% Medicare, 22% Medicare Advantage, 9% self-pay Services: Individual psychotherapy, psychological testing and evaluation, psychiatric diagnostic evaluations, group therapy, telehealth sessions
