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Behavioral Health Practice Case Study

Recovering $680,000 in abandoned high-volume psychotherapy denials using Parity Act statutory citations.

ClearPath Behavioral Health Network · 35 Clinicians across 5 Outpatient Facilities · Denver, CO · Systems: Tebra / Kareo, TherapyNotes

Recovered Cash
$684,200
10 months
Appeals Filed
4,320 claims
Automated batch review
Staff Overtime
Zero hours required
Sustained

The Challenge

With average psychotherapy claims of $140, ClearPath could not afford to pay billers $57 in administrative time to fight each CO-50 medical necessity denial. As a result, 88% of denials were never worked.

The Breaking Point

Denial write-offs were eroding 14% of the network's operating margin, forcing leadership to reconsider commercial payer contracts.

The Solution & Implementation

ClearPath activated RecoupOps's batch appeal engine, which automatically grouped similar denials by payer and injected Federal MHPAEA Parity Act citations into every dispute letter.

Commercial insurers were systematically denying legitimate mental health care, counting on the fact that small practices can't afford to fight back. RecoupOps leveled the playing field overnight. We recovered nearly $700K with zero staff burnout.
Shalini Jaikishan, JD
Chief Compliance Officer, ClearPath Behavioral Health
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