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Challenge
Before Athelas
Like many growing orthopedic practices, Ortho Plus was doing strong clinical work but losing ground on the financial side. Manual processes, limited visibility, and a rising volume of unresolved claims were creating friction across the revenue cycle:
- Missed underpayment flags and lost revenue opportunities
- Below-benchmark patient collections, averaging $29.43 per encounter
- A low first-pass rate causing claim rework and delayed payments
- Nearly $92K in denied claims across 387 unworked encounters
- High reliance on patient responsibility with no tools to streamline collection
- Delayed submissions and open encounters leaving revenue on the table
Solution
After Athelas
After implementing Athelas, that friction gave way to clarity. With smarter automation, deeper insight, and hands-on RCM support, Ortho Plus turned each of those gaps into a measurable win:
- $368K in additional patient revenue collected
- $56K recovered from 951 previously denied claims
- 1.9% denial and rejection rate—well below the industry average of 5–10%
- +12% increase in patient collections per encounter
- $101.82 insurance collected per encounter, surpassing the $101.27 benchmark
- 91% first pass rate, exceeding Athelas’ internal benchmark
- 98% of encounters fully closed, with claims submitted in just 3 days on average
- 82% of eligibility collected onsite, contributing to $27K in recent in-office collections
- 96%+ of total claims reconciled to date
Result
Key Improvements
With Athelas, Ortho Plus has gained more than a set of tools. They've gained a partner invested in their long-term success. Denials are down, payments move faster, and the team no longer spends its days chasing claims or piecing together fragmented reports. Providers can focus on patient care with confidence that the financial side is running with the same precision as the clinical side.
Patients now experience a smoother, more transparent financial journey. Eligibility is verified up front, balances are clearer, and onsite collections are captured before small gaps turn into lost revenue. What used to be a source of friction has become a competitive advantage.
The results speak to what's possible when orthopedic practices pair strong clinical care with a revenue cycle system built for how they actually operate: high procedure volume, complex payer mix, and no tolerance for preventable denials.
See how Athelas, powered by Commure, can help your transform your revenue cycle:
- Improve collections with automated workflows and real-time financial visibility
- Reduce denials through intelligent claim scrubbing and proactive payer management
- Empower your team with AI-driven tools that eliminate manual follow-up
- Create a better patient experience with clear billing, upfront eligibility, and easier payment options
Whether you're a single-location practice or a multi-site group, Athelas delivers the visibility, automation, and operational support you need to grow with confidence.
Schedule a demo today.
