🏥 Challenge — Multi-center anesthesia group losing revenue, providers & patients
An anesthesia practice operating across several surgery centers in the Southeast US saw its top-line cash flow deteriorate year-over-year because payer fee schedules (PFS) were not kept current. Key issues:
- Major payors were still paying at 2016 commercial fee levels for a payer that represented ~35% of patient volume.
- Patient volume was slipping to nearby competitors who had better payer participation.
- Declining reimbursement made it difficult to retain qualified providers.
🔧 Solution — Medikigai partnership: credentialing, contracting and revenue-first playbook
Medikigai implemented a focused 7-month program that combined contracting, credentialing and targeted patient-recapture tactics:
- Participating contracts negotiated with a large commercial payor (Commercial & Medicare Advantage).
- Credentialing Center of Excellence executed payer follow-ups, contract appeals and effective documentation to reset payer decisions.
- Targeted outreach and contract-based marketing helped win back patients who had moved to competitors.
📈 Results — measurable turnaround in 7 months
The outcomes were clear and financial:
- Patient volumes increased by 22% month-over-month after former patients returned.
- The largest payer agreed to a double-digit percentage rate increase, projected to generate $548,000 additional cash over the next 5 years.
- Participating provider contracts with the commercial payor were completed successfully, restoring in-network billing and improving collections.
- Faster credentialing + better rates reduced billing losses and improved provider retention.
⚡ Why this worked
- We combined our commercial contracting expertise with persistence — not just paperwork but targeted negotiation.
- We prioritized the payer representing the largest volume first, which unlocked the biggest immediate revenue gain.
- Patient-recapture tactics tied contract wins to real-world revenue (not just theoretical improvements).
🟩 Want similar results for your practice?
If your practice is operating with outdated payer rates or struggling to keep patients or providers, Medikigai can run a short audit and showcase immediate opportunities to maximize revenue and optimize your U.S. staffing costs.
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