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Behavioral health · 12 providers · Southeast US

Multi-Location Mental Health Group

A growing mental health group reduced denials and gained weekly revenue visibility after switching from an in-house billing team.

Challenge

Denial rate exceeded 14% due to auth tracking gaps and inconsistent telehealth coding across locations.

Solution

Pro Nexus deployed a dedicated denial specialist, standardized telehealth coding rules, and implemented weekly KPI reviews.

Results

MetricBeforeAfter
Denial rate14.2%5.8%
Days in AR4734
Net collections91%97%
Clean claim rate89%96%

Within four months, our denial rate dropped from 14% to under 6%. Pro Nexus gave us weekly visibility we never had with our previous vendor.

Practice Administrator

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