Denial Management Cardiology & Interventional Radiology San Francisco, CA (16 Physicians)
Pacific Cardiovascular Institute: Reducing Claim Denials by 91% in 90 Days
Eliminating cardiac procedure denials, prior authorization bottlenecks, and modifier errors for a high-volume cardiology practice.
Published January 2026 6 min read
91%
Denial Reduction
Drop in initial claim denials
99.4%
Clean Claim Rate
First-pass claim rate
+$1.2M
Net Revenue Lift
Annualized collection growth
The Challenge
- Initial claim denial rate averaging 16.5% on interventional cardiology procedures.
- Prior authorization write-offs exceeding $250,000 annually.
- Uncollected patient co-insurance balances past 90 days.
The Solution & Strategy
- Deployed automated AI claim scrubbing rules catching NCCI edit bundling conflicts before clearinghouse dispatch.
- Automated electronic prior authorization verification 72 hours prior to scheduled cardiac cath procedures.
- Implemented pre-service cost estimates and SMS text-to-pay patient billing portals.
Quantifiable Key Results
Denial Rate
1.5%
91% denial reductionClean Claim Rate
99.4%
Up from 83.5%Prior Auth Write-Offs
0%
100% elimination"Reducing our denial rate by 91% restored cash flow stability across all 3 of our cardiac surgical centers. YAKKAY Healthcare delivered beyond expectations."
Dr. Michael Chen, MD, FACCExecutive Director at Pacific Cardiovascular Institute
Actionable Takeaways for Practice Leaders
1
Deploy automated AI pre-scrubbing engines tuned to interventional cardiology NCCI edit guidelines2
Verify prior authorization status 72 hours prior to elective catheterization appointmentsReady to Achieve Similar Results?
Schedule a complimentary Revenue Cycle Audit for your practice to pinpoint billing leaks and clean claim opportunities.
Organization Profile
Organization:Pacific Cardiovascular Institute
Specialty:Cardiology & Interventional Radiology
Location & Scale:San Francisco, CA (16 Physicians)
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