Resources - Case Studies

Results our clients can measure

Every story here started with a revenue cycle problem someone had already tried to solve in-house. Here's what changed, and what the numbers looked like after.

Across these engagements
98%
Documentation accuracy
99.9%+
ROI request quality
150,000+
Requests per month
$10.8M
Aged A/R reviewed
$808,905
Recovered for one client
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01Medical Coding
Multispecialty hospital - Multiple US locations7,500 employees

Reduced denial rates and reached 98% documentation accuracy in just two months

Missing diagnosis codes were quietly driving up rejections. Two months in, accuracy hit 98% - and the client handed over four more specialties.

98%
Documentation accuracy
24-hr
Turnaround on pending claims
4
Additional specialties secured

The challenge

  • High rejection rates from inconsistent coding
  • Missing diagnosis codes driving frequent denials
  • No backup resources to absorb volume spikes
  • Rising salary costs tied to new hires

The Valerion Health solution

  • Assigned a dedicated coding subject-matter expert
  • Identified the root causes behind claim denials
  • Built a practice-specific coding policy and escalation process
  • Stood up offshore processing capacity for volume coverage

The results

Rejections dropped almost immediately as accuracy climbed to 98%. Compliance improved and backlogs cleared on a 24-hour turnaround - enough for the client to hand over coding for four additional specialties.

Denials climbing for reasons no one has pinned down?

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02Medical Coding
Multispecialty hospital, second-largest employer in its area750 employees

Fixed workflow bottlenecks to bring monthly closes and turnaround back on schedule

Before a chart reached the coding team it had already passed through three departments. We untangled the hand-offs and put one person on the client's side of the line.

24-hr
Turnaround on fresh worklists
100%
Month-end closes on schedule
1
Dedicated onshore liaison

The challenge

  • Multiple hand-offs across clinical, pharmacy, and data-entry teams before coding
  • Duplicate work from charge additions and deletions on the client side
  • Staffing gaps during month-end closes, especially on weekends
  • Communication gaps between the coding team and client

The Valerion Health solution

  • Deployed a dedicated onshore resource as the client interface
  • Standardized day-end reporting and a master worklist for aging accounts
  • Added staffing coverage through month-end close windows
  • Set a weekly cadence for clearing old worklists

The results

Month-end closing came back inside its timeline and fresh worklists now clear within 24 hours. Clearer visibility into each chart's lifecycle resolved the confusion that had been slowing the coding team down.

Is the process around your coders the actual bottleneck?

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03Release of Information
ROI & document management provider1,001–5,000 employees

Delivered 99.9%+ quality on Release of Information requests while doubling operating hours

Cost pressure had capped staffing, and targets were slipping with it. We moved onto the client's own platform, doubled the operating day, and pushed accuracy past 99.9%.

99.9%+
Accuracy on requests
150,000+
Requests processed monthly
16-hr
Operating window, up from 8

The challenge

  • Falling efficiency and on-time completion of requests
  • Staffing constrained by cost pressures
  • Missed quality and turnaround targets
  • Client satisfaction slipping as a result

The Valerion Health solution

  • Launched an indexing process directly on the client's own platform
  • Ran a phased, planned ramp-up of the transition
  • Extended operations to 16 hours a day, doubling the prior window
  • Launched special projects targeting persistent problem areas

The results

Quality reached 99.9%+, ahead of target, with document security and patient privacy compliance holding throughout. The team now processes more than 150,000 requests a month, with dedicated projects still working down the toughest remaining cases.

Need more hours in the day without more cost per hour?

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04End-to-End RCM
Physician group11–50 employees

Improved collections by 5% and cut payment-processing costs by 60% within six months

Two vendor changes in one year had left this group with no visibility into its own revenue. Six months later, billing was in-house and 90% of what had been billed was collected.

+5%
Improvement in collections
−60%
Card-processing cost
90%
Of billed amount recovered

The challenge

  • Switched billing vendors twice within a single year
  • No visibility into billing, denials, or payment data
  • No control over turnaround times or contract terms
  • Repeated disruptions to billing access

The Valerion Health solution

  • Rolled out a business intelligence system with full reporting access
  • Transitioned billing completely in-house within six months
  • Introduced a performance management system and moved all ERA/EDI
  • Updated contracts and surfaced missing agreements with three major payers

The results

Dashboards, daily reporting, and payment reconciliation replaced what had been a blind spot. Collections rose 5% as eligibility and prior-authorization issues eased, and moving card processing to a preferred third-party system cut those costs from 3.5% to 1.4%.

In total, the client recovered $808,905 of $912,737 billed - a 90% collection rate.

Changed vendors and still can't see your own numbers?

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05A/R Collections
Home infusion & community pharmacy1,001–5,000 employees

Recovered 62% of outstanding claims within six months

Nearly $10.8M sat in claims over 120 days old, half of it on its way to write-off without ever being reviewed. We worked the queue claim by claim.

62%
Of outstanding balance recovered
$10.8M
In aged claims reviewed
120+
Day-old claims reworked

The challenge

  • Nearly $10.8M stuck in bad debt on claims 120+ days old
  • Half of those accounts headed for write-off, unreviewed
  • Staff bandwidth stretched thin prioritizing fresh claims
  • A number of claims had never been billed to insurers at all

The Valerion Health solution

  • Built combined onshore and offshore teams for the backlog
  • Prioritized claims by dollar value
  • Conducted an in-depth review of every claim in the queue

The results

The team recovered nearly 62% of the outstanding balance, turning accounts the client had all but written off into real collections - strong enough that the client extended similar 120+ day claim work.

How much of your write-off pile has never actually been reviewed?

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Your turn

Have a backlog, a denial rate, or a close date that keeps slipping?

Tell us where it hurts - we'll show you what the first 90 days would look like.

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All figures reflect results achieved during the engagements described. Client names withheld by agreement.