Case Studies
Real results from real practices. Every case study represents actual performance improvements achieved by Go Medical Billing clients. Names and identifying details have been changed to protect client confidentiality.
Cardiology Group Recovers $340K in Annual Revenue
!The Challenge
A 6-provider cardiology group was experiencing a 16.2% initial claim denial rate, A/R days averaging 62, and a growing backlog of unworked claims over 90 days. Their in-house billing team of 3 was overwhelmed by the volume and complexity of interventional cardiology coding. Cardiac catheterization bundling errors, missing modifiers on multi-vessel PCI claims, and inconsistent prior authorization tracking were causing preventable denials on high-dollar procedures worth $2,000 to $15,000 each.
Our Solution
The Results
Results measured over first 12 months
Key Actions & Outcomes
“We didn't realize how much revenue was falling through the cracks until Go Medical Billing showed us the data. The cath lab coding alone was costing us six figures a year in preventable denials. Within 90 days, the difference was obvious in our bank account.”
Urgent Care Network Eliminates 45-Day Billing Backlog
!The Challenge
A 4-location urgent care network was drowning in billing backlogs. Their in-house biller had resigned, and a temp staffing solution was submitting claims 30 to 45 days after the date of service. With 60+ patients per day per location, thousands of claims were piling up. Timely filing denials were mounting. E/M coding was inconsistent across locations, with some providers defaulting to level 3 (99213) for 80% of visits regardless of complexity. Ancillary services (rapid tests, X-rays, nebulizer treatments) were frequently performed but not captured on the charge ticket.
Our Solution
The Results
Results measured over first 6 months
Key Actions & Outcomes
“When our biller quit, we panicked. Go Medical Billing took over all 4 locations in two weeks and cleared the backlog in a month. But the real surprise was how much revenue we'd been leaving on the table with undercoding and missed charges. Our collections jumped 40% and we didn't see a single additional patient to get there.”
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Internal Medicine Practice Adds $180K with Care Management Codes
!The Challenge
A 5-provider internal medicine practice had stable collections but suspected they were leaving money on the table. Their denial rate was acceptable at 8%, but A/R days had crept to 48 and their net collection rate was only 91%, below the 95%+ benchmark. More critically, the practice was not billing any care management codes (CCM, TCM, AWV add-ons) despite managing a predominantly Medicare patient panel with multiple chronic conditions. The G2211 visit complexity add-on code, available since January 2024, was not being billed at all.
Our Solution
The Results
Results measured over first 12 months
Key Actions & Outcomes
“I had no idea we qualified for chronic care management billing. We were already doing the work, calling patients, refilling medications, coordinating referrals, but we weren't capturing any of that revenue. Go Medical Billing set up the CCM program, added the G2211 code we'd been missing, and found underpayments we never would have caught. An extra $180,000 in the first year without seeing a single additional patient.”
Behavioral Health Group Stops a $48K Quarterly Takeback Pattern
!The Challenge
A multi-clinician outpatient behavioral health group came to us mid-takeback. UnitedHealthcare's automated 90837 review had flagged 14 months of session billing and was demanding repayment of $48,000 across 312 sessions. The group's documentation supported the work but did not consistently include time entries with what filled the time. A second issue compounded it: telehealth sessions delivered after the PHE flexibilities tightened were missing modifier 95 on roughly 9% of claims, generating quiet downcoded payments the team had not noticed. Their EHR (TheraNest) supported time documentation through templates but the templates were not being used.
Our Solution
The Results
Takeback resolution: first 90 days. Documentation compliance: ongoing measured at 6 months.
Key Actions & Outcomes
“The takeback letter from UHC nearly broke us. Our previous biller told us to just pay it. Go Medical Billing read every chart, filed the responses, and got 85% of it reversed. They also rebuilt our note templates so this could not happen again. A year later we are running clean and our 90837 utilization actually went up because the documentation finally supports it.”
Orthopedic Group Recovers $87K of Post-Op Revenue from Global Period Modifiers
!The Challenge
A 4-surgeon orthopedic group performing 220+ major joint and spine cases per year was capturing the surgical revenue but losing post-op revenue inside the 90-day global windows. Their previous billing service did not flag global-period overlap on the practice schedule. Encounters during global periods were billed without modifier 24 (unrelated E/M), modifier 79 (unrelated procedure), or modifier 78 (related return to OR), so the work either bundled into the original procedure or denied entirely. Their EHR (NextGen) showed the global-period status but the billing workflow did not surface it at the time of charge entry.
Our Solution
The Results
Retroactive recovery: first 6 months. Ongoing capture rate measured at 12 months.
Key Actions & Outcomes
“I had no idea we were leaving this much on the table. We do the work, the patient comes in for an unrelated complaint while they are in the global period, and we never billed it because nobody flagged it. Go Medical Billing built the report, retrained us on the chart language, and recovered $87K we would never have seen.”
GI Practice Recovers $61K from CO-97 Bundling Appeals on Endoscopy
!The Challenge
A 3-gastroenterologist practice with an attached ASC was running 1,400 endoscopies per year. Their previous biller wrote off CO-97 bundling denials on 18 to 25 claims per month, mostly on combinations involving 43239 (EGD with biopsy) paired with same-session colonoscopy codes, and on 45380 (colonoscopy with biopsy) bundled into 45385 (colonoscopy with snare polypectomy). The practice manager had a sense the appeals were winnable but nobody on the team had time to look up the NCCI indicator on each pair, and the previous biller defaulted to write-off after one denial.
Our Solution
The Results
Retroactive recovery: 90 days. Sustained reduction in CO-97 write-off: 12 months.
Key Actions & Outcomes
“We knew the appeals were probably winnable but nobody had time. Go Medical Billing did the indicator lookup on every code pair, pulled the charts, and won 73% of the appeals. The bigger win is that we stopped generating most of these denials in the first place. Their scrubber catches the pattern before submission now.”
Our Methodology
All case study metrics represent actual client performance improvements. “Before” metrics are measured from the 3-month period prior to Go Medical Billing engagement. “After” metrics are measured at the timeframe specified in each study. Client names and identifying details are anonymized to protect confidentiality. Individual results vary based on practice size, specialty, payer mix, and baseline performance.
We Serve 40+ Medical Specialties
These case studies represent a fraction of the specialties and practice types we work with.
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