Overview
As a multi-specialty telemedicine provider expanded its virtual care services, reimbursement performance became increasingly difficult to manage across Medicare, Medicaid, and commercial payers. Inconsistent application of telehealth billing requirements, documentation gaps, and evolving payer policies contributed to growing denials, underpayments, and more than $420,000 in outstanding telehealth receivables.
AnnexMed conducted a comprehensive review of the provider’s telehealth revenue cycle, identified the primary causes of reimbursement leakage, and implemented a targeted recovery strategy. Within 60 days, the engagement recovered $275,000 in outstanding telehealth claims, reduced telehealth denials, and strengthened billing workflows to improve future reimbursement performance.
Key Challenges
Inconsistent Telehealth Billing
Frequent payer updates around telehealth modifiers, POS codes, and provider eligibility resulted in inconsistent claim submissions across Medicare, Medicaid, and commercial plans.
Documentation Gaps
Incomplete clinical documentation and inconsistent coding reduced first-pass acceptance, leading to avoidable denials and repeated payer requests.
Aging Claims Inventory
Denied and underpaid telehealth claims accumulated as internal teams prioritized new submissions, leaving significant recoverable revenue untouched.
Limited Denial Visibility
Without structured denial analysis, the organization had limited insight into recurring payer issues and recovery opportunities.
Our Recovery Approach
Claims Prioritization
AnnexMed reviewed outstanding telehealth claims, prioritizing high-value accounts based on payer deadlines, denial reasons, and recovery potential.
Coding and Documentation Review
Certified coders validated telehealth modifiers, POS selection, diagnosis coding, and supporting documentation before claims entered the appeal process.
Targeted Appeals
Payer-specific appeal workflows were developed using complete clinical documentation and current virtual care reimbursement requirements to maximize recoveries.
Performance Monitoring
Recovery dashboards tracked appeals, payer turnaround times, recovered revenue, and recurring denial trends to support ongoing process improvements.
How We Did It
- Reviewed outstanding telehealth claims across multiple payers to identify recovery opportunities.
- Prioritized claims using denial trends, filing deadlines, and financial impact.
- Validated coding, documentation, modifiers, and POS accuracy before appeal submission.
- Executed structured payer follow-up until claim resolution.
- Delivered ongoing reporting to improve future telehealth reimbursement performance.
Solutions Impact
$275K
Recovered in 60 Days
41%
Reduction in telehealth Denials
96%
Coding validation Accuracy
35%
Reduction in unresolved Telehealth AR
Proven RCM expertise. Delivered at scale.
For over 20 years, AnnexMed has delivered RCM solutions nationwide, combining expert billing, coding, and AR support to drive measurable results and growth.
- 20+ years of proven healthcare RCM experience
- 2,000+ professionals supporting billing, coding & AR
- 500+ certified coders across multiple specialties
- 99%+ compliance with HIPAA and security standards
- All 50 states served with consistent, scalable operations
