How VANAA Helped a Client Scale Its Monthly Reimbursements Nearly 4x
Behavioural health clinic
30–40 patients daily
~30% reimbursement rate at start
Majority of claims denied
4×
reimbursement growth over 3 years
100%
of backlog claims recovered in 3 months
30% → 90%+
reimbursement rate
Executive Summary
Client Profile
- Behavioural health clinic
- 30–40 patients daily
- ~30% reimbursement rate at start
- Majority of claims denied
Only 30% of the clinic’s claims were being paid, the majority denied without explanation, and the previous billing company couldn’t find the cause. VANAA’s root-cause analysis uncovered a payer system glitch: a major payer had mistakenly inactivated one of the clinic’s providers. Within three months VANAA recovered the full claims backlog and restored reimbursements; over three years, monthly reimbursements grew nearly 4×.
The Problem
- ~30% reimbursement rate, with most of the expected value going unpaid
- High claim denials with no clarity on payer rejection reasons
- Previous billing partner unable to identify or resolve the issue
- Cash flow insufficient to support operations and growth
The Solution
AI-augmented tooling, human-led execution, in the order the work happened.
01
Root-cause analysis
- Reviewed claims, eligibility checks, payer policies, and denial trends
- Isolated the issue to one major payer, not the clinic's own processes
02
Discovery of a payer system glitch
- Found the payer had mistakenly inactivated one of the clinic's service providers in their system
- The error caused widespread denials despite accurate submissions
03
Resolution & advocacy
- Engaged directly with payer management with evidence of correct claim practices
- Persistent follow-up over three weeks led to system correction
04
Recovery & prevention
- Recovered the full backlog of claims within three months
- Ongoing monitoring ensured future claims processed correctly
Measurable Impact
Business Impact
Annual reimbursements nearly quadrupled across three years. The extra cash flow funded more providers and patient services, and the clinic upgraded VANAA’s engagement from fixed staffing to revenue-sharing, a long-term strategic partnership.