The Hidden Revenue Wake-Up Call: A Private Practice Story

“I didn’t realize how much money we were leaving on the table until we partnered with Pivotal. Total game changer.”
— Private Practice Therapist, New York, NY

The Problem: Quiet Losses Add Up

This solo therapist had been running a successful private practice in New York for years. She was booked out, had a loyal caseload, and assumed her billing was fine.

But when her monthly deposits didn’t line up with what she was expecting, she reached out for a second opinion — just to be safe.

“I didn’t think we were losing money… until I saw how much we weren’t collecting.”

What We Found: Missed Claims, Silent Denials, and Hidden Gaps

We ran a full billing audit and quickly uncovered the leaks:

• Claims never submitted due to EMR errors

• Out-of-network reimbursements left unchased

• Denials quietly stacking up with no follow-up

• Eligibility not verified — resulting in patient responsibility write-offs

In short? She wasn’t being underpaid — she wasn’t getting paid at all for a chunk of her work.

The Fix: Small Tweaks, Big Payoffs

We implemented:

• Weekly claims tracking + denial follow-up

• Upfront eligibility and benefits verification

• Documentation support to prevent future rejections

• Payer-specific coding tweaks to boost approval rates

Within 30 days, we had claims flowing. Within 60? Her revenue was up by over 28% — without seeing a single extra client.

The Results: More Revenue, Same Workload

“It wasn’t about working harder — it was about getting paid correctly for the work I was already doing.”

Don’t Wait for a Crisis — Get Clarity Now

You don’t have to be in chaos to need help. Sometimes the biggest problem is what you don’t see.

Let’s make sure you’re not leaving money on the table, too.