Client: Pacific Heart and Wellness Clinic (Name changed due to confidentiality)
Location: Seattle, WA
Engagement Start: January 2025
The Situation
Early 2025, a Seattle cardiology practice was still grappling with long-standing ICD-10 coding challenges that had complicated healthcare billing since 2015. Coupled with rising patient expectations and increasing claim denials, their outdated manual billing processes led to payment delays, overwhelmed staff, and patient confusion over medical bills.
Where Things Were Going Wrong
The practice faced several key issues that complicated their billing:
Persistent ICD-10 coding complexity: Despite years of ICD-10 use, coding errors remained high due to frequent updates and unclear guidelines, causing regulatory compliance risks.
High denial rate: A significant 22% of claims were denied right away, which severely impacted their incoming payments.
No clear insights: They couldn’t figure out why payments were delayed or denied.
Frustrated patients: Bills were confusing, and payment choices were few.
They clearly needed a complete change to their billing system, not just a bit of help.
What Rapid RCM Did
In January, Rapid RCM Solutions stepped in with a full-scale plan to fix the process and bring in better results.
Upgraded Billing System: Replaced manual, disconnected workflows with an integrated online platform synced to patient records, reducing errors and boosting efficiency.
Enhanced ICD-10 Coding Accuracy: Implemented advanced validation tools that flagged coding mistakes before claim submission and monitored denied claims in real-time to identify root causes.
Improved Patient Experience: Rolled out an easy-to-use online portal enabling patients to verify insurance coverage instantly, view simplified bills, and select flexible payment plans.
Staff Training: Provided ongoing education on ICD-10 updates, payer-specific rules, and HIPAA compliance to reduce future errors.
Data-Driven Insights: Developed dashboards offering clear visibility into claim performance, payment timelines, and process bottlenecks for proactive management.
| Key Metrics | Before | After |
| Claim Denial Rate | 22% | 6% |
| Average Days in AR | 44 | 21 |
| Patient Collection Rate | 74% | 92% |
| Patient Satisfaction Score | 3.1 out of 5 | 4.7 out of 5 |
| Monthly Revenue Increase | – | $180,000 |
| Time to Payment | – | Cut by 52% |
| Manual Entry Time | – | Down by 60% |
| Compliance Gaps | – | Zero audit issues |
In Their Words
“The experience with Rapid RCM Solutions changed our billing process altogether. Their technology and guidance didn’t just improve cash flow. They gave our team space to focus on patient care again.”
– Dr. Renee Martin, Medical Director
The Outcome
By addressing persistent ICD-10 coding challenges with modern technology, staff training, and patient-friendly tools, the clinic transformed its revenue cycle in just three months. The result wasn’t just stronger finances but a more confident team and happier patients.
