Challenge
Before Athelas
Arizona Urology is a private practice built on strong clinical care and a stable financial foundation for the patients and staff who depend on it. But like many independent practices, the team had a nagging question that traditional RCM could never quite answer: are insurance companies actually paying us based on what our contracts say?
For years, the practice ran on a traditional RCM model that kept the billing team perpetually on the back foot:
- Claims sat in the same buckets week after week, and staff resubmitted fixes only to watch the same claims linger.
- Denials had to be investigated one by one, with no visibility into shared root causes across payers.
- No one could confirm whether payers were reimbursing at the negotiated contract rates. In fact, one payer alone had paid the practice $37,000 less than what they owed over the previous year.
- Effort was going in, but AR was not coming down, and the strain was showing up in patient satisfaction and staff morale.
Solution
After Athelas
Arizona Urology partnered with Athelas to rebuild its revenue operation around real data and AI driven prioritization:
- Contract level underpayment reporting. Fee schedules were loaded into Athelas, and custom reports now flag the discrepancy between what should have been paid and what was actually paid, giving the team hard evidence to bring back to payers.
- AI prioritization. The platform surfaces the highest impact claims based on live trends and continually refines its rules against real practice data.
- Payer categorized claim view. A centralized workspace groups claims by payer so staff can resolve batches of similar denials together instead of reinvestigating each one.
- A unified front desk homepage. Patient name, date of birth, insurance, and outstanding balance all appear on one screen, so front desk staff can collect during the charge and give patients answers on the spot.
Result
Key Improvements
With Athelas, Arizona Urology moved from reactive billing to a data driven revenue operation:
- $37,000 in underpayments from a single payer surfaced and now recoverable, with ongoing monitoring against every posted payment.
- A more productive billing team, with staff able to work multiple claims for the same insurance at once.
- AR trending down, with corrections going out in a timely manner.
- Patient collections up exponentially, thanks to real time visibility at the front desk.
Beyond the numbers, what stood out was the change in relationship. RCM stopped feeling like a black box and started feeling like a partnership.
"Switching to Athelas, you will definitely get the service that probably is lacking in most RCM companies. You're being heard, and that you're being seen. And that's something honestly that Athelas does really well."
-Dr. Pankaj Jain, Co-Founder
