Two growing outpatient medical centers, under same owner, in the United States were looking to improve reimbursement performance without increasing patient volume.
While patient visits remained consistent, opportunities existed to improve coding accuracy, strengthen documentation practices, reduce reimbursement leakage, and maximize revenue generated from each patient encounter.
The centers partnered with Lister to manage the billing process, provide coding oversight, and create a structured feedback system that would improve both compliance and financial outcomes.
The centers followed a standard three-day claim submission process, with charges entered three days after the date of service.
While claims were being submitted on time, several revenue cycle challenges limited reimbursement potential:
Inconsistent E&M Level Selection
Providers were not always selecting the most appropriate Evaluation & Management (E&M) level supported by documentation.
This created two significant risks:
Providers often lacked structured feedback regarding coding opportunities and documentation deficiencies.
Without a systematic review process, educational opportunities were being missed.
Rather than focusing solely on claim submission, Lister implemented a proactive documentation and coding improvement strategy designed to optimize reimbursement while maintaining compliance.
Structured Pending Log Management
Lister introduced a comprehensive pending log process that categorized outstanding items by:
This structured approach enabled the client to quickly route follow-ups to the appropriate team members and resolve issues efficiently.
Every encounter underwent an additional quality review before claim submission.
When documentation supported a higher E&M level than originally selected:
When documentation did not support the selected E&M level:
Rather than treating coding corrections as isolated events, Lister created an ongoing educational process.
Providers received regular feedback regarding:
Over time, this improved both coding confidence and documentation quality across the organization.
Following Lister’s documentation review and provider education initiatives:
This improvement reflected better documentation, more accurate coding, and stronger provider awareness.
The team:
The team:
As a result, approximately 70% of denied claims were successfully overturned and paid.
As coding accuracy improved, both centers experienced substantial growth in revenue generated per patient visit.
Level 4 utilization increased from 44% to as high as 89%.
Level 4 utilization improved from 46% to as high as 90%.
A key achievement of this engagement was that financial performance improved without relying on additional patient visits.
This enabled the centers to maximize revenue from services already being provided.
Credentialing-related out-of-network denials represented a significant reimbursement challenge.
Through detailed appeal submissions and persistent payer follow-up, Lister successfully recovered payment on approximately 70% of denied claims.
This created an immediate positive impact on collections and cash flow.
This engagement demonstrates that meaningful revenue growth does not always require more patients, it often requires capturing the full value of the care already being delivered.
By combining documentation improvement, coding oversight, provider education, denial recovery, and proactive revenue cycle management, Lister helped these two medical centers significantly improve reimbursement performance while maintaining compliance.
The result was a stronger, more accurate revenue cycle, higher revenue per patient, and a scalable framework for long-term financial success.
Every patient encounter represents revenue your practice has already earned, but only accurate documentation and coding ensure you receive the reimbursement you’re entitled to. Lister works alongside providers to improve documentation quality, strengthen coding accuracy, and maximize compliant reimbursement without increasing patient volume. If you believe your practice may be under-coding or missing legitimate reimbursement opportunities, we’d be happy to assess your current billing performance.
Proven RCM expertise. Measurable 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 $1500) and discover practical opportunities to improve your financial performance.
