Healthcare practices don’t lose money because of “big problems.”
They lose money because of silent operational leaks that no one notices until the bank balance exposes the damage.
Two of the biggest leaks — the ones that quietly drain tens of thousands every quarter — are:
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Weak Verification of Benefits (VOB)
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Incorrect or mismatched CPT coding
If you don’t take these seriously, your practice is burning cash long before claims ever hit the payer.
1. Poor VOB: The Fastest Way to Destroy Your Cash Flow
Verification of Benefits is not a “clerical task.”
It is your first defense against denied claims, rejected payments, and angry patients.
When VOB is done poorly, you get operational chaos:
Operational Impact
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Surprise patient balances → patients delay or avoid payment
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Preventable denials → coverage not active / HMO mismatch / wrong plan
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Rework on every claim → your staff spends more time fixing than billing
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Revenue lag → AR spikes and cash flow collapses
Most practices don’t realize the damage until AR is 60–90 days deep — and by then it’s already expensive.
2. Wrong CPT Codes: The Revenue Kill Shot
CPT coding mistakes don’t just cause denials — they create underpayments, compliance risk, and lost revenue you will never recover.
These errors happen because:
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staff rely on outdated cheat sheets
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authorization codes don’t match billed codes
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modifiers are missing
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the team doesn’t do medical policy checks
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systems aren’t synced with payer requirements
Financial Impact
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Immediate denials → delays of 30–60 days
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Underpayments → payer processes the claim but pays less
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Overpayments & audits → compliance flags, clawbacks, penalties
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MCO/MCO-authorized code mismatches → guaranteed rejections
One wrong code repeated across multiple visits can quietly wipe out thousands per month.
3. How Practices Can Stop These Leaks Today
This is where profitable practices differentiate themselves.
Standardize VOB With a Rigid Workflow
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Real-time plan validation
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Detailed plan benefit extraction (HMO vs PPO, carve-outs, auth rules)
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Documentation of patient financial responsibility
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Always verify MCO specifics (CareBridge, EVV requirements, etc.)
Upgrade Your Coding Controls
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Cross-check CPT vs authorization
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Daily coding QA
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Policy-driven coding rules by payer
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ICD–CPT medical necessity mapping
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Monthly coding audits
Automate Wherever Possible
Automation won’t fix everything, but it eliminates human inconsistency.
Outsource to Experts Who Do This at Scale
Internal teams struggle because VOB and CPT coding require:
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precision
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speed
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payer expertise
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system knowledge
Your revenue depends on accuracy, not luck.
Why Practices Partner With VIS Medical Billing
VIS Billing LLC helps clinics protect revenue across the entire billing lifecycle.
Our team brings 11+ years of RCM expertise across:
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Eligibility & VOB
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CPT/ICD-10 coding alignment
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Claims submission
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Denial management
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AR recovery
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Medicaid, MCO, CareBridge workflows
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Multi-state payer compliance
Our clients see measurable outcomes:
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Faster reimbursements
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Lower denial rates
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Reduced AR days
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Higher collection ratios
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Cleaner claims from day one
When your VOB is precise and your CPT coding is correct, revenue stops leaking — and your practice finally stabilizes.
