The 40% Billing Accuracy Win for a US Healthcare Client
Client
A prominent physician group based in Texas, known for serving patients across a wide range of medical specialties, found itself wrestling with long-standing problems in its revenue cycle. Patient numbers were rising, and insurance rules kept changing, which made it hard for the group to keep up. They needed to improve billing without cutting corners on patient care.
Industry:
Healthcare
Location:
UAE
Tools & Technologies:
Challenges
The group had a clear goal: to bring in $1,000,000 million in monthly revenue by improving how they handled billing and insurance claims. However, that goal remained out of reach due to frequent claim rejections and processing delays. A significant portion of these denials resulted from inaccurate CPT coding, incomplete documentation, and unverified insurance eligibility—issues that slowed down reimbursement cycles and demanded considerable manual effort to correct.
Beyond initial submission issues, the group also faced major workflow gaps in the back-end process. There was no consistent system for tracking or following up on pending claims, which led to delayed resubmissions and revenue loss. Unresolved claims piled up due to poor tracking and the absence of a structured escalation framework. Moreover, the billing team lacked adequate training in physician-specific coding, including proper use of modifiers and familiarity with payer-specific requirements. These knowledge gaps led to repetitive mistakes and high denial rates.
Our Solutions:
To address these pressing challenges, TronsIT Solutions implemented a comprehensive security framework anchored by Proofpoint’s Endpoint Data Protection solution. This automated cloud-based platform ensured continuous, policy-driven backups across all endpoints—laptops, mobile devices, and desktops—allowing seamless data recovery in case of failure or attack. The Proofpoint system was integrated with real-time monitoring and reporting tools, ensuring all data activities were logged and aligned with HIPAA compliance requirements. TronsIT also established a centralized management dashboard, enabling the IT team to enforce security policies and track backup status across the organization.
In tandem with the endpoint backup deployment, the client adopted a layered security approach including Data Loss Prevention (DLP), Security Awareness Training, Vulnerability & Penetration Testing, and Incident Response planning. Proofpoint’s phishing simulations and behavioral training modules significantly improved staff resilience to social engineering attacks. Vulnerability scanning and penetration testing were scheduled quarterly to proactively identify and mitigate potential endpoint security gaps. These enhancements allowed for real-time compliance reporting and a reduction in security event response time, ultimately building a culture of cyber readiness and data stewardship throughout the organization.
Significant Outcomes

Enhanced
Billing Accuracy
Improved billing precision by 40%, resulting in a substantial reduction in coding-related claim denials.

Recovered
Unpaid Claims
Successfully retrieved over $180,000 in outstanding claims within the first 90 days of implementation.

Faster
Claims Processing
Accelerated claims cycle by reducing processing time by 55%, contributing to improved revenue flow.

Improved
Coding Proficiency
Increased staff accuracy in coding by 60% through focused training on modifiers and payer-specific guidelines.

Strengthened
A/R Management
Streamlined follow-up and escalation procedures, leading to a 30% reduction in aged accounts receivable.