Case study · The Care Clinic

A clean-claim rate above 95%, and cash arriving in half the time.

The Care Clinic is a multistate outpatient psychiatry and mental-health practice, and the environment Resova iQ was built in. Denials, staff turnover and no revenue visibility were costing it real money. This is what changed, and how it was measured.

95%+
Clean-claim rate
<1%
Denial rate
2×
Faster to collect

For comparison: most practices run first-pass clean-claim rates of 75–85% against HFMA’s 95% benchmark; average initial claim denial rates reached 11.8% in 2024; and the median practice carries roughly 47 days in A/R (MGMA 2024 Cost and Revenue Survey).

Internal results at a single practice over 2025–2026. Not an external benchmark, and not a projection for your group.

The challenge

The clinical side worked. The back office did not.

Board-certified psychiatrists and nurse practitioners were seeing patients across 33+ states. Behind them, claims went out with errors and bounced back as denials. Cash arrived weeks late. Revenue visibility lived in one biller's spreadsheet — and in that biller's head. Every departure stalled the pipeline, and notes were finalized days after the encounter.

Before

  • Roughly three in four claims went out clean
  • Nearly one in five claims denied
  • More than a month, on average, to collect
  • Revenue visibility in one spreadsheet
  • Every staff departure stalled billing
  • Notes finalized days after the visit

After

  • Clean-claim rate above 95%
  • Denial rate below 1%
  • Time to collect more than halved
  • Live dashboards for the whole team
  • Workflows that survive turnover
  • Same-day drafts, provider-signed

What actually changed

Three things moved the number.

Errors caught upstream

Eligibility, coding and payer-specific checks run before submission rather than after rejection. Most denials are not billing failures — they are documentation and eligibility failures that surface at the claim.

Exceptions stopped queueing

Payer responses route to the desk that can resolve them — front desk, credentialing, clinical or patient outreach — instead of collecting in one person's inbox until someone noticed.

Corrections stuck

Each correction was captured with its outcome and, after review, promoted into a rule. That is why the rate did not spike and fall back — the same error stopped recurring.

We built Resova iQ because our own practice was losing real money to billing busywork. Once the denials stopped and the cash showed up faster, it was obvious this was not just our problem.

Sidd Arora
Sidd Arora
Founder & CEO · The Care Clinic and Resova iQ

How this was measured

The honest version.

These are internal figures from the practice where the product was built, compared against its own baseline over 2025–2026. Clean-claim rate is first-pass acceptance; denial rate is denied claims over claims submitted; time to collect is average days in A/R.

Software was not the only thing that changed in that window — staffing and payer mix moved too, and we have not tried to separate those effects. We do not yet have an external, independently measured deployment to point at. When we do, we will publish the methodology alongside it.

If you want to pressure-test whether any of this transfers to your group, the most useful thing you can send us is your current clean-claim rate, denial rate and days in A/R. We will tell you where we think the gap is, and where we do not know.

Talk to us

Run your numbers against ours.

Send us your provider count, states, EHR and claim volume, and we will come to the first call with something specific to your practice.

Start the conversation