Case Studies

Revitalizing Claims Processing Efficiency to Clear Backlogs: A Success Story with a California-Based Medical Billing Company


Founded in 2009 and situated in California, our client is a well-known medical billing company with a strong expertise in proficiently handling claims, payments, and billing processes. Their core specialization lies in providing comprehensive solutions to healthcare providers, ensuring seamless and efficient management of financial aspects within the medical industry.

The client needed assistance to efficiently handle a high volume of healthcare benefit claim forms and documents, aiming to eliminate backlogs and establish a scalable and standardized solution for their ongoing needs.

We offered a comprehensive solution to the client, including dedicated teams for efficient claim processing, a phased transition plan to clear backlogs, and the implementation of an automated system for streamlined claim capture and adjudication.

The Story of our Customer

  • Established in 2009 and based in California, our client is a distinguished player in the medical billing domain..
  • They specialize in streamlining the complex billing procedures that healthcare providers encounter, offering a comprehensive suite of services including claims processing, payment tracking, billing management, and revenue cycle optimization. Their adept team of professionals works to ensure accurate and timely claim submissions, efficient payment tracking, and effective resolution of billing discrepancies.
  • The client faced challenges in efficiently managing a high influx of healthcare benefit claim forms and documents due to their complexity and diverse types. This led to a mounting backlog of claims, posing a risk to customer relationships . Hence they sought our partnership to address the backlog and establish a scalable, flexible, and standardized solution.

The challenge faced by our Customer

Confronted with a daily influx of thousands of healthcare benefit claim forms and related documents, the client struggled with the intricate nature of forms, variety in document types, and time-consuming processes.

  • High volume of healthcare benefit claim forms and related documents received daily.
  • Complexity and diversity of forms and document types.
  • Tedious processes causing difficulties in managing the inflow of work.
  • Accumulation of a growing backlog of claims.
  • Need to preserve the client's customer relationships.
  • Seeking a service provider to clear the backlog and establish a scalable, flexible, and standardized solution for future needs.

The Solution

In response to the challenge, a strategic solution was devised to optimize claim processing and overcome the backlog issue. The approach was multi-faceted, involving expert teams and innovative technologies to enhance efficiency and accuracy. The solution encompassed:

  • Strategic selection of specialized professionals to handle claim processing.
  • Thorough investigation to refine reimbursement procedures and document handling.
  • Implementation of a comprehensive phased transition strategy.
  • Creation of an efficient document management system.
  • Integration of an automated system for swift claim capture.
  • Streamlined electronic claim submission and reduced manual errors.

The Result

The client greatly benefited from our tailored solution, realizing enhanced operational efficiency and improved financial performance. The key advantages encompass:

  • Reduced Denial Rate: Claim denials dropped by 30% within three months and further by 80% in the following three months.
  • Backlog Clearance: Drastic reduction and eventual elimination of pending claims backlog.
  • Timely Collection: Efficient and timely collection of all claims.
  • Substantial Savings: Achieved a remarkable 40% increase in revenues within six months.

Through our solution, the client achieved substantial improvements across their revenue cycle, establishing a more streamlined and profitable financial operation.

Leverage Med Billing Expert to Serve the Customers Better

Med Billing Experts stands as a premier business process outsourcing firm, boasting skilled professionals located within 5 global delivery centers worldwide. Our comprehensive array of services spans inbound support to outbound call center solutions, providing a holistic resource encompassing human expertise, process acumen, advanced technology, infrastructure support, and rigorous quality assurance measures – all geared toward amplifying the scalability of your business operations.

If you seek a dependable, lucrative, and synergistic healthcare BPO partner to realize your goals, we encourage you to establish prompt contact with us