How Valetudo Doubled Monthly Collections With Atlas

We began working with Valetudo shortly after they fired their previous, overseas, biller. The previous company had worked in secret without providing updates, so company leadership was not aware of the depth of the situation. They had seen the money going into their bank account drop as they saw more and more patients. Their first ask of us was to diagnose the problems and report back.

The challenge

The problems ran deeper than just the typical backlog of denied, unaddressed claims.

• Incorrect eligibility verification. The clinic’s EMR was reliably returning incorrect eligibility results because it could not differentiate between state Medicaid and its managed care organizations. The front desk was verifying patients against the wrong plans, leading to an eligibility denial rate of nearly 15%.
• Undercoded claims. Visits were being coded incorrectly, missing key components of the patient’s visit that should have been captured and billed. Providers were delivering comprehensive evaluations and therapy sessions, but the billing codes didn’t reflect the full scope of work.
• No visibility into billing performance. Leadership had no reporting, no dashboards, and no way to tell what was working and what wasn’t. The previous biller had provided no updates for months.
• Untapped service lines. The clinic wanted to expand into speech and occupational therapy alongside their core psychiatry work, but hadn’t started the credentialing process to bill for those services.

For a 7-provider practice seeing nearly 2,000 patients, collections were far below where they should have been.

What we did

Correct CPT coding. We audited Valetudo’s claims and found that visits were being undercoded across the board. Providers were delivering comprehensive evaluations and therapy sessions, but the billing codes didn’t reflect the full scope of work. We implemented correct CPT coding that captured all aspects of the patient’s visit, including add-on codes and extended session times that had been consistently missed.

New eligibility tools for the front desk. The EMR’s built-in eligibility check was the root cause of the 15% denial rate. We gave the front desk new eligibility verification tools that could properly distinguish between Medicaid and its MCOs, catching mismatches before claims were ever submitted. We also ran full automated eligibility checks every night so the front desk knew exactly which patients to collect updated insurance cards from the next day. The eligibility denial rate dropped from nearly 15% to under 2%.

Expanded service lines. We worked with the clinic to credential new providers and open new lines of speech therapy and occupational therapy alongside the core psychiatry work. This gave Valetudo additional revenue streams from patients who were already in their care, without adding significant overhead.

Results

Despite the difficult starting point, Valetudo’s turnaround was substantial. Monthly collections more than doubled, and revenue per claim increased 15%. The eligibility denial rate dropped from 15% to under 2%, meaning the front desk was no longer the bottleneck in the revenue cycle.

More importantly, Valetudo now has full visibility into their billing. No more surprises, no more claims sitting in limbo. The clinic’s leadership can see exactly where their revenue stands and make decisions based on real numbers.