How a Mental Health Practice Recovered $186,400 in Revenue by Improving A/R Management

What Alarming Revenue Challenges Were Holding Back Collections?

The practice's financial challenge was not a lack of billable services. The bigger issue was that some earned revenue was not moving efficiently through the payment cycle.

Growing A/R Over 90 Days

A portion of outstanding insurance balances remained unpaid beyond 90 days. Older accounts required more attention and presented a greater risk of becoming difficult to recover.

Gaps in Account Follow-Up

Follow-up activity was not always prioritized by account value, aging, payer, or recovery potential. Without a consistent tracking process, some accounts received less attention than their financial value warranted.

Preventable Billing Issues

Problems involving eligibility, patient details, coding, documentation, and payer requirements were sometimes discovered only after claims had been submitted, creating additional work and payment delays.

Missed Reimbursement Variances

Payments were being posted, but reimbursement was not always systematically compared with the expected amount. This created opportunities for potential underpayments to remain unidentified. These challenges demonstrated the need for a connected revenue-cycle process rather than isolated billing activities.

Revenue Recovery Strategies to Address Billing Gaps

Star Billing Solutions introduced a structured medical billing services for mental health providers designed to address immediate A/R opportunities while improving the processes responsible for future collections.

1. Ranked Outstanding Accounts by Recovery Potential

The outstanding A/R was reorganized using key factors such as account age, balance, payer, non-payment reason, and likelihood of recovery. This created a practical priority system and helped the team spend more time on accounts with meaningful financial value.

2. Added More Pre-Submission Checks

The billing workflow was strengthened with additional reviews of eligibility, patient information, coding, documentation, authorization requirements, and payer-specific rules. Identifying issues earlier helped reduce the number of problems reaching the payer unnecessarily.

3. Introduced Account-Level Follow-Up

Rather than reviewing A/R as one large outstanding balance, individual accounts were assigned specific actions and follow-up dates. This gave the team a clearer record of what had been done, what remained unresolved, and what needed to happen next.

4. Examined Reimbursement Against Expected Payment

Payment activity was reviewed to identify potential differences between expected and received reimbursement. Where discrepancies were identified, the accounts were routed for appropriate investigation and follow-up.

5. Created Better Performance Visibility

Reporting was improved to give the practice a clearer view of aging balances, collection activity, unresolved accounts, and overall revenue-cycle performance. This allowed management to identify problems earlier rather than discovering them after collections had already been affected.

Measuring the Six-Month Turnaround Results

The changes produced measurable improvements across the practice's revenue-cycle performance. The primary financial result was $186,400 in recovered revenue. The practice also achieved a significant improvement in 90+ day A/R, increased its clean claim rate, and reduced the denial rate. Following are the detailed improvements with key figures.

• Recoverable Revenue Identified: $186,400 recovered opportunity (from $0 tracked to $186,400)
• 90+ Day A/R: Reduced from $312,000 to $198,000 (36.5% decrease)
• Days in A/R: Reduced from 67 days to 46 days (31.3% improvement)
• Clean Claim Rate: Increased from 86.2% to 95.1% (8.9-point increase)
• First-Pass Resolution: Increased from 72.4% to 89.3% (16.9-point increase)
• Denial Rate: Reduced from 11.8% to 6.4% (45.8% decrease)
• Net Collection Rate: Increased from 88.7% to 95.6% (6.9-point increase)

These improvements show the value of addressing multiple stages of the revenue cycle rather than focusing on one billing activity.

The assessment reviewed the practice's A/R aging, unpaid accounts, payment activity, billing procedures, payer responses, and outstanding balances. The review uncovered $186,400 in recoverable or delayed revenue, consisting of:

• $71,600 in aging insurance A/R
• $43,200 in unresolved payer balances
• $38,900 in potential underpayments
• $21,700 in accounts requiring corrected billing or additional action
• $11,000 in other recoverable balances

The assessment also revealed that management needed better visibility into core revenue-cycle indicators. Tracking measures such as clean claim rate, denial rate, days in A/R, first-pass resolution, and net collection rate made it easier to evaluate whether process changes were producing meaningful results.

The central finding was clear: the practice had revenue already generated but not fully collected.

Key Takeaways From the Case Study

Earned Revenue Still Needs to Be Managed

Providing a service does not guarantee timely reimbursement. Revenue can remain outstanding because of payer issues, coding problems, eligibility gaps, underpayments, or insufficient follow-up.

Aging A/R Requires a Strategy

An A/R report tells a practice how much money is outstanding, but prioritization helps determine where the team should focus first.

Payment Review Can Reveal Additional Opportunities

Recording payments is only one part of the process. Reviewing reimbursement against expected amounts can help uncover potential discrepancies.

Prevention Reduces Future Revenue Leakage

A strong recovery process should not only address old balances. Better eligibility checks, claim review, documentation, and follow-up can help prevent similar problems from recurring.

Revenue-Cycle Metrics Matter

Tracking collection and billing performance gives practice leaders measurable evidence of what is working and where additional improvements may be needed.

For behavioral health practices, behavioral & mental health billing services should support the full revenue lifecycle. Combining accurate billing with mental health billing RCM, A/R management, payment reconciliation, and consistent follow-up can give practices greater control over their revenue.

Maximize Your Practice's Revenue Recovery With Star Billing Solutions

Unresolved A/R can represent more than an accounting problem; it can represent revenue your practice has already earned but has not yet collected. Star Billing Solutions LLC provides medical billing services for mental health providers covering claims management, coding support, A/R follow-up, payment posting, denial management, and revenue-cycle optimization. If your practice is dealing with increasing A/R, recurring billing issues, or unexplained collection gaps, reviewing the revenue cycle can help identify where opportunities are being missed.

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• Phone: +1 480 525 3676
• Email: [email protected]
• Website: www.starbillingsolutions.com