Medical Billing and RCM Support for Specialty Practices
Every specialty brings different billing patterns, payer rules, documentation needs, and denial risks. CG Meditrans supports specialty and general medical practices with structured RCM workflows built around claim accuracy, follow-up, and visibility.
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Select a specialty below to see common billing challenges, risk areas, and how CG Meditrans can support your RCM workflow.
Medical billing case studies
Revenue Cycle Management Case Studies by Specialty
These anonymized CG Meditrans case studies show how disciplined eligibility verification, prior authorization support, credentialing, clean claim submission, denial management, payment posting, and A/R follow-up can improve collections for US medical practices.
7 specialty workflows$1.2M recovered revenue exampleUp to 190% practice growth
Case Study 01Family Medicine
Family Medicine RCM Turnaround: From $760K to $2.2M
A family medicine practice had declining revenue and more than half of collections trapped in 90+ day A/R. CG Meditrans rebuilt the revenue cycle foundation, recovered old balances, and helped the practice scale.
Challenge
More than 50% of the practice revenue was stuck in aging A/R. Providers were seeing patients, but collections were not keeping pace with clinical work.
CG Meditrans response
Cleaned up old accounts receivable and prioritized stuck claims.
Reduced the 90+ day A/R bucket through structured follow-up.
Identified missed CCM/RPM service opportunities and supported practice expansion.
Case Study 02Pain Management
Pain Management Billing Recovery: From $20K to $175K per Month
A high-volume pain management provider was seeing 30 to 40 patients per day but collections were far below clinical effort. CG Meditrans rebuilt billing submission, documentation, and A/R follow-up workflows.
Challenge
Workers Comp claims were going out without complete records, private payer billing was still paper-heavy, and unpaid claims were not being worked consistently.
CG Meditrans response
Moved private payer claims to electronic billing.
Attached supporting medical records to Workers Comp claims.
Created clean-claim checks before submission and stronger follow-up queues.
Case Study 03Cardiology
Cardiology Revenue Leakage Recovery: $1.2M Found Without More Visits
A cardiology practice had full schedules and exhausted providers, but revenue did not match the work being performed. CG Meditrans focused on front-end controls, denial root causes, and A/R recovery.
Challenge
Prior authorizations were inconsistent, eligibility was not always verified, documentation delays slowed claims, and aging A/R did not have disciplined follow-up.
CG Meditrans response
Tightened eligibility and authorization checks before visits.
Reviewed denial patterns to resolve root causes instead of only resubmitting claims.
Created a systematic A/R follow-up process for unpaid claims.
Case Study 04Gastroenterology
Gastroenterology RCM Stabilization After an Epic Transition
A gastroenterology practice moved to Epic and had a large share of revenue trapped in old A/R. CG Meditrans helped stabilize billing operations, EDI workflows, credentialing, and payer contracts.
Challenge
After the EMR transition, 60% of revenue was stuck in 90+ day A/R. Missing records, surgical requests, EDI setup gaps, and Medicare credentialing issues were delaying payment.
CG Meditrans response
Supported Epic and EDI workflow setup with payer connectivity.
Recovered backlog claims by tracking missing records and surgical requests.
Reviewed payer contracts and supported better-paying plan participation.
Case Study 05Psychiatry
Psychiatry Practice Launch: Two Providers From $0 to $1.68M
Two psychiatrists left a group practice and launched independent practices. CG Meditrans supported the administrative, credentialing, EMR, and billing foundation needed to scale cleanly.
Challenge
Both providers were starting from zero and needed payer credentialing, group setup, PTAN linking, benefit assignment, fee schedules, and electronic claim infrastructure.
CG Meditrans response
Secured Type 2 organization NPI setup and payer credentialing workflows.
Linked individual PTANs to group PTANs and assigned benefits.
Configured EMR, fee schedules, and electronic claim pipelines.
Case Study 06Ophthalmology
Ophthalmology Surgical Billing Rebuild for Cleaner Payment
An ophthalmology practice had inconsistent cash flow and high denials around surgery claims. CG Meditrans rebuilt eligibility, authorization, ASC billing, payer rules, and surgical claim workflows.
Challenge
Surgical billing was split across professional and facility components, CMS-1500 and UB formats, different tax IDs, ASC reimbursement policies, and one dominant payer with complex rules.
CG Meditrans response
Improved pre-service eligibility, ASC authorization tracking, and COB cleanup.
Built payer-specific appeal templates and ASC variance monitoring.
Supported credentialing, EFT/ERA enrollment, and MIPS reporting.
Case Study 07Mobile PET Imaging
Mobile PET Imaging Growth: From Medicare Denials to Multi-State RCM
A mobile PET imaging laboratory had Medicare claims denied because accreditation was not recognized in Medicare systems. CG Meditrans resolved the enrollment issue and built a scalable multi-state revenue cycle.
Challenge
Medicare denied submitted claims because the accreditation information had not been updated in its enrollment system, blocking collections and limiting growth.
CG Meditrans response
Opened and followed a Medicare enrollment case until accreditation was updated.
Built eligibility, authorization, EFT/ERA, claims, posting, and A/R workflows.
Supported Arizona expansion and commercial payer enrollment.
Want to find the bottlenecks in your revenue cycle?
Book a Free Revenue Cycle Check to review denials, A/R aging, eligibility gaps, authorization issues, credentialing delays, and payment posting workflows.
