Medical billing case studies
Five practices, measured before and after BilNow took over their billing. Every figure comes from the practice’s own billing records for the period shown, compiled by our operations team under Harris Mahmood, Director of RCM and Credentialing Operations. We name the specialty and state, not the practice.
Mental health group, California
What we found at takeover
- Eligibility errors causing avoidable denials
- Credentialing gaps delaying claims
- No structured follow-up on unpaid claims
What we did
- A full eligibility-verification workflow before each visit
- AR worked by age bucket and dollar value
- Credentialing and enrollment gaps closed with each payer
- Denial root-cause analysis with corrective fixes
- Escalation routes with payers for stuck claims
Period measured: 6 Feb 2025 – 31 Aug 2026. Source: practice billing records.
Pain management practice, New Jersey
What we found at takeover
- Most claims sitting in the 90+ day bucket
- About 40% of claims were workers’ compensation, no-fault or auto accident, each with its own rules
- A 35% denial rate
What we did
- Worked the aged AR oldest-first, by dollar value
- Applied the correct workers’ comp, no-fault and auto claim rules
- Eligibility verification before every visit
- Denial analysis and appeals, with payer escalation
- Ongoing claim monitoring so new AR does not age
Period measured: 1 Oct 2025 – 31 Aug 2026 (results reached in 60 days). Source: practice billing records.
Integrative clinic, California
What we found at takeover
- Eligibility errors driving avoidable denials
- Credentialing and enrollment gaps
- No structured AR follow-up
- Timely-filing denials still open
What we did
- Eligibility verification rebuilt end to end
- AR prioritized by age, value and payer response time
- Credentialing and enrollment discrepancies fixed
- Timely-filing denials appealed and recovered
- Denial root-cause fixes and payer escalation
Period measured: 9 Apr 2025 – 31 Aug 2026. The remaining 2% of denials are medical-necessity records waiting on the provider. Source: practice billing records.
Physical and occupational therapy practice, Texas
What we found at takeover
- Eligibility errors causing avoidable denials
- Credentialing and enrollment gaps delaying claims
- No structured follow-up on unpaid claims
- Timely-filing denials still open
- Little visibility into where each claim stood
What we did
- An eligibility-verification workflow before each visit
- AR worked by age, dollar value and payer response time
- Credentialing and enrollment discrepancies fixed with each payer
- Timely-filing denials appealed and tracked to resolution
- Denial root-cause analysis with corrective fixes
Period measured: 24 Mar 2025 – Sep 2026. Source: practice billing records.
Behavioral health group, Texas
What we found at takeover
- Claims rejected by a Medicaid managed care plan for taxonomy errors
- Timely-filing denials with a regional payer
- Progress notes not signed by the provider
- A provider’s Medicaid enrollment left unresolved
What we did
- Fixed every taxonomy-related rejection with the plan
- Filed timely-filing appeals
- Flagged unsigned notes and missing authorizations to the provider for completion
- Resolved the provider’s Medicaid enrollment
- Fixed eligibility and modifier errors and wrote billing guidelines so claims go out correctly
Period measured: 19 Aug 2025 – Sep 2026. Source: practice billing records.
All results at a glance
Before BilNow → with BilNow, from each practice’s own billing records.
| Metric | Mental health group, California (19 providers) | Pain management, New Jersey (2 providers) | Integrative clinic, California (7 providers) | PT and OT practice, Texas (5 providers) | Behavioral health group, Texas (6 providers) |
|---|---|---|---|---|---|
| First-pass claim acceptance | 80% → 99.6% | 65% → 95% | 60% → 98% | 60% → 98% | 70% → 95% |
| Denial rate | 20% → 0.4% | 35% → 5% | 40% → 2% | 40% → 2% | 30% → 5% |
| AR over 90 days | 32% → 0.4% | 80% → 10% | 40% → 1% | 40% → 2% | 75% → 14% |
| Days in AR | 30 → 18.95 | Most claims past 90 → 15 | 40 → 16 | 40 → 16 | 35 → 20 |
| Monthly collections | $24,926 → $155,605 | $25,000 → $60,000 | $5,951 → $24,008 | $2,342 → $11,110 | $87,793 → about $100K |
| Aged AR recovered | $12,650 | $300,000 | $14,950 | $6,820 | Being verified |
| Time to results | 90 days | 60 days | 90 days | 90 days | 160 days |
| Period measured | 6 Feb 2025 – 31 Aug 2026 | 1 Oct 2025 – 31 Aug 2026 | 9 Apr 2025 – 31 Aug 2026 | 24 Mar 2025 – Sep 2026 | 19 Aug 2025 – Sep 2026 |
Frequently asked questions
Are these real practices?
Yes. They are BilNow clients. We show the specialty and state only, to protect client privacy, and every figure comes from the practice’s own billing records for the period shown.
How quickly did results show?
In these five cases, results showed within 60 to 160 days of taking over the billing.
Will my practice see the same results?
Results depend on where your billing starts. Book a free review of your AR, denials and payer mix, and we will show you what we would fix first.
What did these practices pay for billing?
Full-cycle billing starts at 2.7% of collections, with no setup fee and no long-term contract.
Updated September 2026.
We start with a free review of your AR, denials and payer mix. Billing from 2.7% of collections.