Hospital Systems
“We stopped finding out about denial patterns in a monthly report and started catching them before the claim left the building.”
VP of Revenue Cycle, A 6-hospital regional health system
Days in A/R52 days → 19 days
Denial rate11.4% → 3.8%
Coding turnaround3.2 days → 4 hours
Althais for Hospital Systems
Large Multi-Specialty Groups
“Our cardiology and ortho claims used to get denied for completely different reasons. Now both teams work off the same intelligence.”
Director of Billing Operations, A 40-provider multi-specialty group
Denial rate9.8% → 3.1%
Clean claim rate84% → 96%
Avg. coder caseload38/day → 61/day
Althais for Large Multi-Specialty Groups
Private Practices
“I used to do billing on Sunday nights. Now review takes ten minutes between patients and I actually appeal denials instead of eating them.”
Practice Owner, A 3-provider cardiology practice
Time to code a note14 min → 90 sec
Denials appealed12% → 68%
Revenue per claimBaseline → +9.4%
Althais for Private Practices
Urgent Care
“Flu season used to mean a two-week claims backlog. Now Tuesday's visits are submitted by Tuesday night.”
Regional Billing Manager, A 14-location urgent care network
Same-day submission rate54% → 98%
E/M under-coding21% → 4%
Denial rate8.9% → 3.4%
Althais for Urgent Care
FQHCs
“Audit prep went from three weeks of pulling files to two days of exporting a report that was already correct.”
Compliance & Billing Director, An FQHC serving 22,000 patients a year
Medicaid denial rate14.2% → 6.1%
Audit prep time3 weeks → 2 days
Reimbursement capturedBaseline → +12%
Althais for FQHCs
Specialty Clinics
“Our modifier denial rate was the thing we could never fix. It's now the metric we stopped worrying about.”
Billing Operations Lead, A 9-provider orthopedic and sports medicine group
Modifier denial rate16% → 5%
Prior auth prep time45 min → 12 min
Clean claim rate79% → 95%
Althais for Specialty Clinics
Revenue Cycle Teams
“We used to find out what went wrong a month later. Now we see it the day it happens.”
Director of Revenue Cycle Operations, A centralized RCM team supporting 180 providers
Reporting cadenceMonthly → Real-time
Coder throughput45/day → 108/day
Denial root cause ID9 days → 36 hours
Althais for Revenue Cycle Teams
Medical Billers
“Appeal letters used to be the task everyone put off. Now it's a two-minute review, not a twenty-five minute write.”
Billing Team Lead, An independent billing service managing 40 client practices
Appeal letter drafting25 min → 4 min
Claims processed / day / biller32 → 74
Payer portals checked daily6 → 1
Althais for Medical Billers