Case study
Recovering $2.4M in underpayments for an ASC network
A revenue integrity review that reconciled contracted rates against actual remittance.
Client profile
- Organization type
- Ambulatory surgery center network
- Specialty
- Orthopedics, GI, ophthalmology
- Scale
- 9 surgery centers
The challenge
Leadership suspected underpayment but lacked contract modeling. Implant and high-cost supply charges were inconsistently captured across facilities.
The solution
- Revenue integrity and optimization
- Charge capture review
- Payment variance and contract analysis
Our approach
- 1
Modeled expected reimbursement for all major payer contracts.
- 2
Reconciled 18 months of remittance against modeled expectations.
- 3
Audited implant and supply charge capture across all nine centers.
- 4
Filed consolidated variance projects with each payer and standardized the charge master.
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