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A National Behavioral Care Network Built the Billing Capacity to Scale from 1,200 to 2,500 Providers  

The private equity-backed behavioral health provider built a repeatable mid-cycle model that absorbed provider growth, acquisitions, and rising claim volume without scaling billing staff.

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“You can grow as much as you want without having to add FTEs every time you take on more providers or make an acquisition. We’re able to get more productivity as we grow.”

Results at a glance

 Manual review cut from 80% to

less than 25%

Half of claims

move through without biller touch

Up to 33%

of claims corrected automatically

~1% backlog,

processed in hours, not days

Results at a glance

TOUCH
4.2%
4.2%

Reduced denial rate from approximately 15% to 4.2%

TOUCH
1.2 days
1.2 days

Reduced charge lag to approximately 1.2 days, gaining $1M a day

TOUCH
97.5%
97.5%

Achieved 97.5% first-pass, first-pay rate

TOUCH
30%
30%

Reduced FTE counts by 30% through attrition and avoided backfills

Results at a glance

4.2% Reduced denial rate from approximately 15% to 4.2%
1.2 days Reduced charge lag to approximately 1.2 days, gaining $1M a day
97.5% Achieved 97.5% first-pass, first-pay rate
30% Reduced FTE counts by 30% through attrition and avoided backfills

Building for growth

A national behavioral care network had approximately 1,200 providers when it implemented Aptarro’s RCx. Today, it supports more than 2,500 across 90 locations, serving 500 new clients each day. As the organization expanded through acquisitions, its revenue cycle team needed a way to absorb more volume without increasing billing staff at the same rate.

That meant rethinking where billers spent their time. The team needed a process that could separate routine work from the claims that required attention, while still supporting the complexity that comes with multiple payers, providers, and markets.

“Before Aptarro, our billers were looking through every charge, whether it was clean or not,” said the network's Integration and Reimbursement Manager, RCM. “That meant the team touched about 80% of claims. Now, 50% go through clean, at least 25% are auto-fixed, and the team looks at less than 25%.”

Turning expertise into a repeatable process

The care network built a structured model for managing and improving its reimbursement logic over time. The platform automatically handles routine corrections—adding telehealth or payer-specific modifiers, correcting rendering provider issues for TMS services, and adding required codes such as H2013 for Medicaid. Coding, billing, AR, and revenue cycle leaders meet weekly to review new requests and keep billing logic aligned with changing payer, coding, provider, and state requirements.

When a new pattern or requirement surfaces, the team determines whether the system should respond differently. That turns frontline reimbursement knowledge into repeatable system intelligence instead of asking individual billers to recognize and solve the same problem again and again. 

“Before Aptarro, our billers were looking through every charge, whether it was clean or not. That meant the team touched about 80% of claims. Now, 50% go through clean, at least 25% are auto-fixed, and the team looks at less than 25%.”

The results

radar
 

Reduced/Reallocated

 

10+ FTEs
 
accuracy
 

Reduced Time

 

from date of service to claim submission by two days
optimization
 

Decreased

 

clearinghouse and payer rejections by 3%
atom-green
 

Improved

 

claim resolution rate by 25%
 
 

The benefits

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The group was able to reduce two full-time positions and reallocate another two full-time positions on their Charge Entry Team. They reduced 11 hours per day of manual charge entry; and automated charge cloning, missing charge reconciliation, and practice transfer. On their AR Team, they were able to reduce four and a half full-time positions and reduce denial tasks by 22%. Finally, on their Coding Team, they were able to reduce two fulltime positions and reduce coding denial tasks by 75%. In all, they were able to reduce or reallocate over ten full-time positions.

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In addition to remedying their staffing challenges, these changes positively increased staff morale and allowed for more professional growth among their existing staff. The simplified processes also eased staffing changeovers and reduced the administrative burden on IT.

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The time from date of service to claim submission was reduced by two days. Their clearinghouse and payer rejections decreased by 3%, backend rejections went from 40% of total rejections down to 15%, and their claim resolution rate three months after implementation was up by 25% of the available opportunity.

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Creating capacity to keep expanding

With routine review falling from roughly 80% of claims to less than 25%, the behavioral care network created capacity to support continued growth and acquisitions. As the organization continues expanding access to care, the team can handle more claim volume without increasing billing staff at the same rate.

That gives billers more time to focus on the smaller share of claims that require judgement, investigation, or intervention.

Owning the process with the right expertise

The network has taken clear ownership of how their revenue cycle is managed and refined, with Aptarro providing expertise when the team needs it. During implementation, the network's team had support tailoring reimbursement logic for behavioral health—determining which edits applied, where custom logic was needed, and how the system should respond to unique payer requirements. The goal wasn’t just to configure the system, but to help their team understand and manage it themselves. As their reimbursement manager put it, “They taught us everything we know.”

That support continued after go-live. A reimbursement intelligence pilot helped the behavioral health network turn denial patterns into opportunities to strengthen reimbursement logic upstream, while the team remained in control of what to prioritize and how to act on those insights.

As their managed explained, “The customer service with Aptarro is amazing. The team is very customer-oriented. They help in any way they can, but they also show you how the system works so you understand it.”

That approach supports the way the provider already works. The team remains responsible for its own revenue cycle strategy and uses Aptarro to strengthen that process, not replace it.