The Challenge: A Specialty Practice Running on Empty
When a leading Wisconsin neurosurgery group came to Encompass Health Solutions, they were facing a problem familiar to a lot of specialty practices: clinical operations were strong, but the revenue cycle was quietly bleeding the business.
The numbers told the story. The practice had more than $1 million in unresolved claim denials sitting on the books. Days in AR were climbing. Denials were eating into margins. Aging receivables were piling up faster than the team could chase them. And like most specialty groups, the practice did not have the in-house coding and billing horsepower to dig out without help.
Their leadership knew something had to change. They just needed a partner who actually understood neurosurgery coding, the nuances of specialty documentation, and the operational discipline it takes to turn a struggling revenue cycle around.
That is where Encompass came in.
The Starting Point: A Free KPI Review
Before recommending anything, Encompass did what we do with every potential client: a complimentary Key Performance Indicator review.
We pulled the practice’s RCM data and looked at the metrics that actually move the needle:
- Denial rate and denial reasons
- Average days to collect
- Clean claim rate
- AR aging by bucket
- Net collection rate
- Coding accuracy across the most common neurosurgery service lines
The review made the opportunities obvious. The practice was not doing anything fundamentally wrong, but documentation gaps, coding inconsistencies, and a slow claims workflow were stacking up to a serious revenue leak. We mapped out exactly where the money was getting lost and what it would take to recover it.
The Engagement: Consulting Plus Scalable RCM Services
Based on the KPI review, the practice engaged Encompass for a combination of consulting and scalable RCM services. Two priorities up front:
- Work through the $1M+ in unresolved claim denials. No revenue cycle improvement matters if there is a mountain of unworked denials blocking the view.
- Rebuild the workflow. Cleaner documentation, tighter coding, faster submissions, smarter denial management.
Our team got to work on both at the same time. While one group of specialists started chipping away at the denial backlog, another worked alongside the practice’s internal staff to tighten clinical documentation (laterality, device location, patient acuity, and the dozens of other details that quietly determine whether a claim gets paid the first time). We also rebuilt the coding and billing workflows so claims went out faster and cleaner.
The Results: Numbers That Speak for Themselves
Here is what the engagement produced.
Operational wins
- $1M+ in unresolved claim denials: worked through. Claims that had been sitting unresolved got reviewed, corrected, appealed, and resubmitted.
- Days in AR reduced by 57%. Revenue that used to take months to land was hitting the practice’s bank account in a fraction of the time.
- AR Aging improved by 10%. The older buckets shrank as collection cycles tightened.
- Denial rate decreased by five percentage points. Cleaner documentation and better coding meant fewer claims coming back.
Financial wins
- Net revenue increased by 18%.
That last number is the one that matters most. An 18% lift in net revenue is the kind of result that changes how a practice operates: more hires, better equipment, more capacity for patients, less pressure on the partners.
And it happened fast. In the practice’s own words:
“At only four months after partnering with Encompass Health Solutions, we achieved historically high revenue cycle performance.”
Director of Operations, Neurosurgery Practice, WI
Why It Worked: Three Things Most RCM Engagements Miss
A lot of revenue cycle consultants will run an audit, hand you a slide deck, and call it a day. That is not the engagement that produced these results. Three things made the difference.
1. We started with data, not assumptions
The free KPI review was not a sales tool. It was the diagnostic. By the time we recommended interventions, we knew exactly which service lines were underperforming, which payers were the biggest denial sources, and where the bottlenecks lived. Recommendations grounded in the practice’s actual data hit different than generic best practices.
2. We owned the work, not just the advice
Plenty of consultants will tell a practice what to fix. Encompass actually did the coding and billing. When you are sitting on $1 million in unresolved denials, you do not need more advice. You need hands on keyboards. Our scalable RCM services let the practice plug in coding and billing capacity exactly where they needed it, without the cost and complexity of hiring full-time staff.
3. We specialize in specialty practices
Neurosurgery is not general medicine. The coding is different, the documentation requirements are different, and the payer rules are different. Encompass codes across a long list of specialties (neurosurgery, neurology, orthopedics, cardiology, anesthesia and pain management, interventional cardiology, cardiothoracic, emergency room, gastroenterology, general and vascular surgeries, physical medicine and rehab, PT/OT, imaging, urology, and women’s health among them). When the people working your claims actually understand the medicine, the results follow.
The Bigger Picture: This Is Not a One-Off
The neurosurgery practice’s results are not an outlier. They are part of a pattern.
Across recent client engagements, Encompass has delivered:
- Client 1: $1,500,000 volume-adjusted year-over-year revenue increase (11% year-one lift)
- Client 2: $550,000 volume-adjusted year-over-year revenue increase (8% year-one lift)
- Client 3: $779,000 volume-adjusted revenue increase in just the first five months of service
Total impact: $2,829,000 in additional revenue for our clients.
That is the kind of money that funds growth, not just operations.
Is Your Practice Leaving Money on the Table?
If any of this sounds familiar (climbing Days in AR, a denial rate that will not budge, a coding backlog you cannot quite get on top of, or just a nagging sense that revenue should be higher than it is), it is worth a conversation.
Encompass offers a complimentary KPI analysis to potential clients. No commitment, no pressure. We will review your RCM data, identify the biggest opportunities, and show you what the numbers could look like with the right interventions in place.
The neurosurgery practice that started with more than $1 million in unresolved claim denials is now running at historically high revenue cycle performance. Your practice’s number is sitting in your data right now. Let us find it.
Get in touch
Email: info@goencompasshealth.com
Phone: 920.202.3371
Toll Free: 844.693.1482