1. The Breaking Point
The clinic wasn’t struggling for patients, they had plenty.
Every week brought in a consistent stream of skin checks, biopsies, excisions, and cosmetic consults. But behind the scenes, the revenue engine was sputtering.
Billing staff were stretched thin, turnover was high, and collections were sluggish. Claims sat untouched. Denials piled up. The front desk was swamped with eligibility issues and authorization delays.
The administrator summed it up simply:
“We aren’t getting paid on time, or in full.”
They knew they needed help. Offshore support seemed promising for the cost savings. But would it fix the deeper process issues?
2. Cost-Saving with Conditions
They approached AnnexMed, not just for staff support, but to test a performance-based partnership. No fixed fees. No hourly rates.
We only got paid if they did. That model gave them confidence, but also pushed us to look deeper. Because for us to succeed, the entire revenue cycle had to be rebuilt.
3. The Partnership in Action
We started with questions, not contracts:
- Why were claims getting delayed?
- Where were codes being missed?
- What was slowing down patient intake and checkouts?
Once we mapped the breakdowns, we got to work.
Here’s what changed:
- Applied coding protocols for procedures like 11102 (shave biopsy), 17000/17003 (AK lesion destruction), and 11400–11446 (benign/malignant excisions) with accurate modifier usage (25, 59, XS) based on NCCI edits
- Created pre-visit eligibility workflows to verify active coverage and check for medical necessity flags on procedures like Mohs surgery and phototherapy, reducing front-end denials
- Designed daily billing batches based on visit type (new, biopsy, follow-up) to ensure clean submission within 24 hours of service
- Implemented aging stratification by CPT group (biopsies, excisions, cosmetic) for targeted AR follow-up based on reimbursement trends
- Took full ownership of charge entry directly from EMR encounter forms, cross-checked with documentation, and built custom payer rule alerts for top carriers
We became their extended billing department.
4. The Payoff
Within the first 90 days, the numbers told the story:
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- 28% increase in collections
- 41% drop in AR over 90 days
- Clean claims rate hit 97.8%
- Over 35% cost savings compared to their in-house model
- No fixed costs, only results-based payments
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What started as a staffing solution turned into a full-scale revenue turnaround.
