CHALLENGE
Rising Claim Volume & Staffing Shortages
Foothill Cardiology, a comprehensive multi-site cardiovascular group in Southern California, faced growing challenges in its revenue cycle operations. With expanding claims volume, the group encountered staffing shortages that hindered claims submission and delayed revenue collection.
As challenges mounted, the group found itself overwhelmed by growing backlogs in both office and hospital charges. Without clear visibility into their claims workflows, it became harder to track progress or spot issues early. Gaps in insurance verification and prior authorization for high-cost diagnostic procedures led to frequent delays and errors. As a result, their denial rate climbed, clean claim rate dropped, and cash flow took a significant hit—putting added pressure on both staff and finances.
SOLUTION
End-to-End Revenue Cycle Management Support
Recognizing the need for expert support, Foothill Cardiology partnered with Infinx to overhaul its RCM strategy through a mix of automation, strategic oversight, and hands-on billing support.
The collaboration began with an RCM Health Check to assess existing gaps, leading to a comprehensive, end-to-end solution across the revenue cycle:
Front-End and Back-End RCM Support
Infinx deployed a dedicated front-end team to manage all claims submissions, ensuring faster and more accurate processing. At the same time, a back-end team tackled $6 million in outstanding accounts receivable, streamlined payment posting, and brought AR days down from 45 to 42—improving cash flow and reducing delays in getting paid.
Charge Entry Optimization
Infinx optimized the group’s charge-capture tool, pMD, at hospital sites to simplify and speed up the billing process. By reducing the time spent entering patient demographics and improving how charges flowed from the point of care to the practice management system, providers were able to focus more on care while billing became faster and more accurate.
Claim Assembly and Submission Enhancements
Infinx improved how the team gathered medical records and attached necessary documentation, helping reduce denials tied to missing medical necessity. Alongside this, they updated claim submission protocols, which led to a major improvement in clean claim rates—from 85% to an impressive 97%.
Patient Access Optimization
Infinx revamped the group’s front-end operations by improving workflows for referral management, insurance verification, benefit checks, and prior authorizations. These changes streamlined day-to-day tasks, reduced delays, and ensured patients were cleared for services more efficiently.
RESULTS
Transformational Results Through a Trusted RCM Partnership
Reduction in Denials and Improved Charge Lag
Just two months after partnering with Infinx, the cardiology group cleared a significant hospital billing backlog and dramatically improved charge lag—reducing hospital delays from 17 to 9 days, and office delays from 8 days to just 2. They reduced initial denials from 12% to under 5%, and total denials from 13% to 7% by fixing coordination of benefits and eligibility issues. The result: faster payments, fewer denials, and a far more efficient billing process.
Revenue and Collection Gains
Over the course of their partnership with Infinx, the cardiology group saw remarkable financial gains. Key performance metrics pointed to sustained improvement in collections, revenue growth, and aging A/R—all contributing to a healthier, more predictable cash flow.
- Achieved a 16% increase in average monthly collections, improving cash flow by $300K/month.
- Gross collection rate rose from 30% to 32% over two years.
- AR 90-120 aging bucket decreased from 20% to 3.5%.
- Average monthly revenue rose from $2.9M in 2022 to $3.47M in April 2025.
- A projected annual lift of 2-3% in collections over the first three years.
“By enhancing our in-house staff to work with Infinx, we were able to make significant improvements. Our mutual goal is to make sure no one has to do the rework. We get the money upfront, we get paid for the services, and everything revolves in a shorter collection cycle.”
— CFO, Foothill Cardiology Medical Group
If you are looking to achieve similar results at your organization, contact us at https://www.infinx.com/request-a-demo.
See how a long-established Southern California comprehensive cardiovascular group faced challenges with staffing and scaling revenue cycle management (RCM) operations in the face of rapidly increasing claims volume.
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