A multi-provider urgent care center was experiencing lower-than-expected reimbursement levels despite maintaining consistent patient volumes. Lister’s review identified a significant opportunity to optimize Evaluation & Management (E/M) coding practices and improve revenue capture while remaining fully compliant with payer and AMA guidelines.
Through targeted coding recommendations, provider education, and ongoing claim reviews, the center significantly increased utilization of appropriate higher-level E/M codes, resulting in improved collections and higher revenue per patient.
The center’s providers were routinely selecting lower-level E/M codes, primarily Level 3 visits, even when documentation supported higher-complexity encounters.
This resulted in:
A review of historical billing patterns showed that the majority of E/M visits were billed as Level 3, while documentation often supported Level 4 coding.
| Month | Level 3 | Level 4 |
|---|---|---|
| Apr '25 | 52% | 47% |
| May '25 | 56% | 44% |
| Jun '25 | 56% | 43% |
| Average | 54% | 45% |
Our team conducted a detailed review of E/M utilization trends and identified several encounters where documentation supported a higher level of service than the code originally selected.
Key findings included:
Lister’s Recommendation
At the end of June 2025, Lister provided the center with:
We recommended a structured provider education initiative focused on Medical Decision Making (MDM)-based coding and documentation best practices.
The center partnered closely with Lister to implement the recommendations.
Process Enhancements
Lister Billing Workflow
The center follows a two-day claim submission process. For example, services rendered on April 1 are entered and prepared for submission on April 3.
To support coding accuracy, Lister implemented a specialized E/M review process:
This proactive workflow reduces compliance risk while improving reimbursement accuracy.
Following provider education and continuous coding reviews, the center achieved a substantial shift toward appropriate Level 4 coding utilization.
| Period | Level 3 | Level 4 |
|---|---|---|
| Apr '25 – Jun '25 | 54% | 45% |
| Dec '25 – Feb '26 | 29% | 69% |
The increase in appropriately documented Level 4 visits directly translated into higher collections.
Collections Improvement
Average monthly collections increased by nearly $10,000 without any increase in patient volume.
Improved Documentation Quality
Through continuous feedback provided within Lister’s pending logs, providers strengthened documentation practices and aligned coding more accurately with clinical complexity.
Level 4 utilization increased from approximately 40–50% before October 2025 to nearly 70% afterward.
Reduction in Accounts Receivable Days
In addition to coding improvements, Lister intensified follow-up efforts on outstanding claims.
| Period | AR Days |
|---|---|
| Nov '25 | 25 Days |
| Apr '26 | 16 Days |
This 36% reduction in AR days improved cash flow and accelerated reimbursement timelines.
As documentation quality and coding accuracy improved, revenue generated per insured patient steadily increased.
Within five months, average revenue per patient increased by 32.94% representing a substantial improvement in reimbursement performance.
Key Takeaways
This engagement demonstrates how strategic coding oversight and provider education can significantly improve financial performance without altering patient volumes or clinical workflows.
By combining detailed E/M reviews, documentation improvement initiatives, and ongoing provider training, Lister helped the center achieve:
The result was a stronger, more sustainable revenue cycle built on accurate documentation and compliant reimbursement practices.
Sustainable revenue growth begins with confident providers, accurate documentation, and coding that reflects the true complexity of the care delivered. Through ongoing coding reviews, provider education, and proactive revenue cycle oversight, Lister helps healthcare organizations improve reimbursement while reducing compliance risk. If you're looking to increase collections without changing your clinical workflows, we’ll help you identify practical opportunities to strengthen both coding accuracy and financial performance.
Whether you’re looking to reduce aged A/R, improve reimbursement, recover unpaid claims, or strengthen your entire revenue cycle, our specialists are ready to help.
Complete the form below to schedule your complimentary Revenue Leakage Assessment (Worth $750) and discover practical opportunities to improve your financial performance.
