Clear Communication. Clean Claims.How One Practice Got Paid — and Smarter — with Pivotal.
How One Practice Got Paid — and Smarter — with Pivotal.
“Pivotal is the first billing company that actually communicates. They fixed our denials, explained the issues, and taught our team what to do differently.”
— Practice Owner, San Diego, CA
The Problem: Denials, Confusion & Radio Silence
This group practice had been working with another billing company for over a year. Claims were going out, sure — but denials were coming in fast and furious… and no one could explain why.
Their clinical team was constantly being asked to “fix the notes” or “resend documentation,” but there was no real guidance on how to improve. They’d submit corrections blindly and cross their fingers. Worse — when they asked questions, they got crickets.
“We were in the dark. We were working harder and still not getting paid.”
The Pivotal Difference: Communication Comes First
We started with a full review of their most commonly denied claims. In one week, we found:
Repeat documentation gaps with specific payers (that weren’t being flagged)
Incorrect coding based on the service type
Clinical notes being written out of sequence for IOP timelines
But we didn’t just fix the claims. We walked them through the why. We created:
Payer-specific cheat sheets
Real examples of strong vs. weak documentation
A custom workflow that tied billing and clinical teams together
The Fix That Lasts
By the end of month one, the practice saw:
81% fewer denials across their top 3 services
A 25% increase in first-pass claim approval
Fewer back-and-forth messages between departments
A clinical team that finally understood what billing actually needed
“We stopped dreading denial reports. We actually started learning from them.”
The Bottom Line
Fixing your billing is great.
Understanding it? That’s where the magic happens.
Ready to Finally Get Answers?
Let’s talk. We’ll audit your denials, explain what’s really going wrong, and teach your team how to avoid it — no finger-pointing, no confusion, just clear communication and real solutions.
