From Chaos Consulting Group LLC

“We’re aggressively following up on the 90-day outstanding claims.”

Okay. But why are they still 90 days old? 😅

Calling the payer every few days and documenting “claim still pending” is follow-up and not an A/R strategy.

A/R management means looking at what’s actually the root cause of the problem and finding the solution:

20 claims from the same payer are stuck in pending?
Find out what’s happening across that payer, not just claim by claim.

The same CO-16 denial keeps appearing?
Find the missing information causing it instead of correcting or reprocessing the same issue every week.

Claims keep rejecting for eligibility or credentialling errors?
That’s a front-end problem, not a “payer is slow” problem.

Claims are denying for no authorisation on file?
Check the dates, approval, units and CPTs against the auth in the payers system and get them corrected.

90+ A/R keeps growing?
Look at the patterns and dollars at risk, not just how many accounts were touched.

Your A/R needs someone to stop asking, “What’s the status?”

…and start asking, “Why does this keep happening?”

Your biller shouldn’t just tell you that the claims were submitted.

They should be able to tell you what happened after those claims left your system and went through the clearinghouse.

Can they answer these five questions clearly?

• What’s driving your denials?
• Are authorizations being tracked before they expire?
• Do your documentation, authorized units, and billed units match?
• How much of your A/R is sitting past 60 and 90 days?
• Where are you seeing revenue leakage from authorization-to-billing mismatches?

If those answers aren’t readily available, you may have gaps in your billing process that are costing you revenue.

Submitting a claim is only one step. The real work is knowing what happens after submission, where claims are getting stuck, and where revenue is being lost.

Saw a comment thread this week: "stay away from flat rate billing." Every comment underneath was a different percentage of the same work. Everything from 3-5.5% of net.

But it’s worth pausing on that advice, because "billing" isn't one thing. The model matters more than the rate structure. And hardly anyone ever mentions that.

When most people hear "biller," they picture the standard setup: an external company working off a spreadsheet, collecting a percentage of what they bring in. That works for a lot of practices. But you're getting someone managing your numbers from the outside, without visibility into your documentation or why a claim actually bounced.

A lot of companies say they work "for you/with you”. Now that language gets thrown around so much it doesn't mean anything anymore.

Here's what embedded actually looks like: a BCBA writes a note on Tuesday that's missing something a payer will flag. If billing is embedded, that gets caught Tuesday, before it's submitted. If billing is external, you usually don't find out until the remit comes back weeks later. Now you're stuck fixing the note, refiling, and waiting again.

Thats the actual outcome difference. It's not about flat rate vs. percentage. It's about whether the person managing your billing is standing next to the work when it happens, or finding out about it after.

New practice owners.. That sprint to the finish line? The one where you're pushing to open two weeks earlier, moving fast on hiring, rushing past the boring back office setup because you just want clients in the door?

It's not buying you what you think it's buying you.

Your finances are going to take 3-6 months to even out from your first date of service. That's not a "if you move fast enough" number. That's how long credentialing, claims processing, and reimbursement cycles actually take. Yes, regardless of how hard you hustle to get there.

You can't out hustle a payer's timeline.

Instead of sprinting to the client, build the foundation thoroughly. I promise, your year 1 you will thank you!

Build the basics:
1. Your intake process, so referrals don't stall out in someone's inbox for two weeks.
2. Your documentation systems, so your BCBAs aren't scrambling to write notes that hold up under an audit, or taking months to turn in assessments and notes.
3. Your billing workflow, so claims go out clean the first time instead of bouncing back and adding another 30 days to your cash gap.
4. Your hiring process, so you're not making desperate hires three months in because you never built a real pipeline (which costs you double the normal hire).

None of this work speeds up a payer's clock. But all of it determines whether you're standing on solid ground when that clock finally runs out. With staff that still want to be with you.

Slow down long enough to build the thing that'll actually hold you up during those 3-6 months.

Your practice management software should make your practice easier to run.

Not just give you more updated features.

The right system can bring scheduling, billing, documentation, reporting, and client communication into one connected workflow, reducing manual work, improving visibility, and giving your team better information to make decisions.

But choosing the right system isn’t just about picking the software with the longest list of features and integrations.

It’s about asking:
→ Does it fit the way your practice actually operates?
→ Can it integrate with the other systems you rely on?
→ Does it give you meaningful data — not just more reports?
→ Can it scale as your practice grows?
→ Will your team actually be able to use it effectively?

Because the “best” practice management software isn’t necessarily the one with the most capabilities.

It’s the tech stack that makes your entire operation work seamlessly together.

And implementation matters just as much as the platform itself.

Data migration. Training. Testing. Integrations. Ongoing optimization.

Those pieces determine whether your new system actually improves your workflow or simply just gives you another system and more chaos to manage.

Your technology should support your practice’s growth.

Not slow it down.

Our referrals page just went live!📣

Referral fees and kickback arrangements are the norm in this industry. We don't take them, and we don't pay them. Every name below gets nothing for being listed. We get nothing for sending you their way.

Here's the thing: the people who helped me along the way rarely asked for anything back either. This field is hard enough without going it alone. If pointing someone toward a person I genuinely trust costs me nothing and helps them, that's reason enough.

A couple of these do things we also do under our own roof. That's not an oversight. We're specifically embedded and ex*****on focused, we grow with a practice longer term. They're specialists in one lane. Sometimes that single lane focus is exactly the right fit, and not us.

So here's who we vouch for, no strings attached:
Melissa Kozak - Caregiver & Parent Training Programs
David Borowski BCBA LBA - Clinical QA & Compliance
Beacon Credentialing - Credentialing support
Chorus Software Solutions - Practice management software
Summit Partnership Group - Business development & growth strategy
Level Up Leadership - Leadership & supervisor coaching
NextEra Strategies - Marketing & social media
Shamaria McMurtry with RBT Ready LLC - Workforce recruiting & staffing
Ellipsis Counseling Center - Mental health counseling
Glow Queen Bri - Esthetics

https://lnkd.in/eREPt2_p

If you're a practice owner drowning in something outside our lane, this is exactly where we'd point you. Stay in touch as this list is subject to incredible growth as we continue to grow alongside some of the best of the best!

Call now to connect with business.

There’s a lot of pressure in the healthcare industry to always be doing more.
More services. More growth. More clients. More revenue.

But sometimes, the best thing you can do for a practice is slow down and first ask, “Does this actually make sense for where we are right now?”

That’s a big part of why From Chaos exists.

We’re not here to sell you something just because we can. We’re here to understand your practice, help you figure out what you actually need, and be honest about what comes next.

Because sustainable growth starts with having the right foundation.

That’s what we believe in. Good work, honest conversations, and putting people before the sales.

You keep the vision. We handle the operations. - Words From Our Founder, Rebecca Frederick

The new From Chaos website is officially here and it's live! 🚀

We've updated our site to offer clear service packages and an improved user experience, helping healthcare practice owners spend less time on operations and more time leading their practices.

Visit https://fromchaos.co/ to view our updated service packages and schedule a discovery call.

Your billing software can do a lot. That doesn’t mean it’s doing it well or that it knows your practice.

SimplePractice, Rethink, CentralReach, AlohaABA etc really pick any platform. They all submit claims, post payments, run reports. Technically capable, sure. But capable of a task and executing it in your favor are two different things.

Here’s what people skip: even when the software “works correctly,” it’s only working with what it was given. What data went in, when, and how it was entered. Wrong modifier, late entry, a guess instead of actual documentation..the system doesn’t know the difference. It just runs the code it’s built to run.

The platform isn’t invested in your outcome. It won’t flag that something feels off, because “off” isn’t its job. Accuracy in, is still on you and your team.

These systems also don’t hold history: your state Medicaid MCO’s latest modifier rejection, the payer that always denies a new client’s first claim, the pattern only someone watching your AR weekly would catch.

Worth checking this week:
→ Pull your AR aging report: anything past 60 days is a pattern, not a fluke
→ Check your last 90 days of denials: same 2-3 codes repeating? That’s a data or configuration issue
→ Ask whoever “handles billing” what they check weekly vs. what just runs automatically in your tools.

The tool isn’t the strategy. Someone still has to watch what it’s doing, and what’s going into it. And initiate those corrections. Otherwise you’re running blind to how much you think you’re earning.