First-Pass Denial Rate Cut 45% and AR Turnover 22 Days Faster
Facing a 16% first-pass denial rate, an aging AR portfolio past 90 days, and a billing team that couldn't keep pace with provider hiring, the network built a 9-person remote RCM pod that now owns coding, charge capture, claim scrubbing, denials, and AR follow-up inside Athenahealth + Waystar.
Available Candidates
Pre-vetted professionals ready to start
At a glance.
What wasn't working.
The network was leaking cash at the RCM layer: 16% first-pass denials, AR > 90 days climbing, and a billing team so stretched that charge capture was running 12 days behind service date. Every new clinic the network opened amplified the problem.
First-pass denial rate was eroding gross margin
Industry median first-pass denial rate sits near 8–10%; the network was running 16% — translating to roughly $4.1M in delayed or permanently written-off revenue annually. The denials team was spending 80% of its time on rework, not prevention.
AR aging was getting worse with scale
AR > 90 days grew from 11% to 19% of total over 14 months. Collection teams couldn't follow up on every account, low-dollar claims were being written off at a $3.2M annual run rate, and the finance team's forecast confidence dropped quarter over quarter.
Local coder hiring didn't match the pipeline
A mid-level AAPC-certified US coder cost $68K–$92K fully loaded with a 12-week hiring cycle. To right-size for the provider count the network needed 6–8 additional coders plus 4 AR specialists — roughly $780K in annual payroll before benefits — unworkable against the network's 7% EBITDA target.
We weren't losing revenue to under-pricing or bad contracts. We were losing it to denials we didn't work, AR we didn't chase, and charges we didn't capture on time. Every one of those is a staffing-capacity problem disguised as an RCM problem.
A pre-vetted Zedtreeo pod.
Zedtreeo deployed a 9-person remote RCM pod within 10 business days. The pod was structured to mirror the network's internal RCM org — AAPC-certified coders, charge-capture specialists, claim scrubbers, denials analysts, and AR follow-up — all operating inside Athenahealth and Waystar with the network's payer rules and LCD/NCD logic.
Team Composition Deployed
A full-stack RCM pod sized to drop denials below 9%, compress AR > 90 days to single digits, and run charge capture in near-real-time across all 38 clinics.
Tools & AI Stack Deployed
The pod operates in the network's existing stack — Athenahealth, Availity, Waystar, Zirmed, Epic — with HIPAA-trained staff, signed BAAs, and payer-rule libraries in place from day one. Delivery runs through the network's existing Athenahealth work queues and RCM ticketing, with payer-by-payer denial trending surfaced weekly.
How it rolled out.
Week 1 — Kickoff & Clearance
Requirements call, BAA attestation, Athenahealth + Waystar access provisioning. Shortlisted pod interviewed by VP RCM in 48 hours.
Weeks 2–4 — Onboarding
5-day free trial on live coding queue and denials backlog. Payer rules library imported, charge-capture SOPs mirrored, scrub rules validated.
Month 2 — Queue Clearance
Full pod ownership of coding, scrubbing, denials, AR. First-pass denial rate drops to 11%. AR > 90 days drops 5 points. Charge capture current.
Months 3–6 — Margin Recovery
Denial rate drops to 8.8%. AR turnover compressed 22 days. 69% cost reduction booked. Pod extended by 2 coders for two new clinic openings.
What changed.
Within one quarter, the RCM function stopped being a cash-leak and became a margin-recovery engine. The finance team regained forecast confidence, and two new clinic openings absorbed into the pod without new payroll hires.
Performance Before → After
Measured improvements across 90 days post-onboarding of the engagement.
Zedtreeo vs in-house hire.
12-Month Cost Breakdown
| Line Item | In-House (US) | Zedtreeo |
|---|---|---|
| Salary + Benefits | $720,000 | $252,000 |
| Recruitment | $42,000 | Included |
| HR & Compliance | $28,000 | Included |
| Tools | $26,000 | Included |
| Total Annual | $816,000 | $252,000 |
In their own words.
The Zedtreeo RCM pod closed our denial-rework loop inside six weeks. AAPC-certified coders, payer-rule discipline, Athenahealth work-queue ownership — it reads like our own team, just bigger and cheaper. 45% lower denial rate and 22 days faster AR turnover are the numbers; the real result is our finance team can forecast cash again.
No dead weeks.
The real cost of a hire that does not work out is not the fee — it is the weeks of ramp, context and half-finished work that go with them. Most guarantees refund the money and hand you a new stranger. Three things happen here instead.
A free replacement, with no expiry
Month one or month thirty — if a specialist stops being right for the seat, we replace them at no cost. There is no 30-day or 90-day cutoff and no cap on how many times you can ask.
A fresh 5-day trial, every time
The replacement is not a stranger you are stuck with. You get five working days of real output to evaluate them, free — exactly the same trial you had on the first placement, on every replacement.
Five free days of handover
The outgoing specialist spends five days handing over to the incoming one, at no charge. Open items get documented and context transfers with the work, so you lose days rather than weeks.
This has been standing practice since we started — it is written down here because it was never written down anywhere. Read the full replacement policy
Roles deployed.
Every role included: AI-tool training, HR management, compliance, and replacement guarantee. Starting from $6/hour, fully timezone-matched globally.
Medical Billing & Coding
AAPC-certified coders, scrubbers, denials analysts, AR specialists. From $800/month.
Revenue Cycle Management
Full RCM staffing — coding, billing, collections, analytics.
Healthcare Virtual Assistants
Patient scheduling, intake, EMR documentation, insurance verification.
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Build a Team Like US Outpatient Specialty Network (name withheld — HIPAA)'s
Get 3 pre-vetted, AI-trained candidates in 48 hours. Starting from $6/hour. 5-day free trial. Save 70–85%.
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Virtual Healthcare Assistants: 3× Intake Capacity
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