Case Study: How a 6-Doctor Nephrology Practice Found $250K
Before hiring another physician, this practice ran our diagnostic. Here's how we found $250K in recoverable revenue, and why the fix wasn't the AI tool they expected.
A six-doctor nephrology practice wanted to expand, but doing so meant hiring another physician and more administrative staff. Since their profit margins were already tight, they asked Camino for guidance on how to move forward and where they could improve right away.
We've simplified the numbers for this case study and kept the practice's name private, but the results are real.
~$40K
Per-doctor revenue recovery
4.5%–7.25%
Improvement in revenue
10%–25%
Improvement in operating income
11% → 3.5%
Billing cost-to-serve
In summary, this six-doctor practice could streamline its operations and recover nearly a quarter million dollars in lost revenue, all while continuing to provide excellent care. And if I'm around, maybe even some great coffee too.
The Diagnostic
This practice operated several locations in a market experiencing a housing boom. They expected to grow and possibly open a new office soon. Before making new hires, they wanted to ensure their operations were as efficient as possible.
Once we understood their goals and situation, we ran our diagnostic. That week, we met with the practice manager, billing manager, and front office team. Here's what we found.
Billing Team
The billing team worked quickly and handled everything in-house, sending claims daily. However, this speed was expensive, costing the practice 10-12% of their collections:
AR Days
~30
Good
Clean Claim Rate
~98%
Good
Denial Rate
~6%
Ok
Downcoding Opportunity
$125K/year
Overall Revenue Leakage
$200K/year
How did this situation develop? The practice manager used to handle billing and ensured payments came in. When pressed for time, she preferred downcoding to avoid interrupting the doctors, but this created hidden costs for the practice. Outsourcing to an RCM wouldn't automatically fix this issue. It also explains why their clean claim rate was so high.
Front Office Team
The front office, however, had some clear areas for improvement:
Staff-Initiated Cancellations
50%
Very Bad
No-Shows
10%
Ok
Provider Utilization
~75%
Overall Revenue Leakage
$55K/year
The main front-office issue was lab work. If patients didn't have their labs ready, the team would cancel their appointments. Without a reminder system or a way to handle labs in-house, this process became chaotic. The team spent many hours each month making cancellation calls.
Expected Productivity Gains
- Back office: 110 hours
- Front office: 210 hours
Because of these challenges, we are now looking at two AI solutions for the next phase. One will automate billing to reduce errors and fatigue. The other will manage outbound reminders and handle incoming calls, especially after hours.
Our Partnership
As we finished phase one, we noticed three other key points. First, the practice manager was handling most of the work and feeling a lot of stress. When we asked what would happen if she left, the answer was, "We'd be screwed." We agreed, and saw that AI could help by giving her more time and reducing her workload. It would also help the team work more consistently.
Second, we realized that "Ambient AI" solutions wouldn't solve their main problems. While these tools could give providers more time, the real issue was the constant stream of cancellations disrupting their schedules.
Third, they could see a clear cash return on their investment within a year. Combined with favorable payment terms, this would keep their cash flow strong as they grew. The productivity gains would also help them handle the extra work as the practice expanded.
We're excited to keep working with this practice. We also partner with primary care and other specialties. If you'd like to run a diagnostic for your practice, click below, and we'll help you get started.