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Case Studies

An illustrative selection of SCALE Consulting case studies.
Case study:

Coding Performance Oversight – Primary Care

Client Profile

40 Providers


Dallas/Ft. Worth, TX

Primary Care
Transplant Medicine

Services Deployed

MSO & Practice Integration

Post-Audit EducationService Title

Revenue Cycle Management


Our Client consists of one high volume practice with four specialties. The Client is an active
participant in government/commercial payer initiatives to deliver value-based care. They had not
implemented a robust coding and clinical documentation program and recognized this as a key
strategic area for performance improvement.

SCALE was engaged to build and manage the practice’s coding and clinical documentation ongoing
monitoring, provider training, and education program.


  • Together with with Scale RCM, we collaborate with our Client to determine the audit focus each quarter, i.e. particular types of claims or payer practice.
  • We audit each provider in the practice once a quarter.
  • We provided additional remediation for providers that fell below a certain performance threshold.


  • SCALE provided strategies to assist our Client in providing clearer documentation & decrease confusion about DX addressed on each DOS.
  • We captured services that require specific documentation elements to be billable and mitigated the risk associated with documentation deficiencies.
  • We implemented a recurring, ongoing program for monitoring and improving performance.
  • Through our assessments, we provided ongoing training and education to all providers in the practice to facilitate best practice in coding documentation.
  • Across the provider team we identified a subset of providers with lower scores/room for improvement, and implemented/augmented reviews, training, and education for the subset.

At re-audit, increased score due to incorrect documentation for audio-only telehealth. After
implementing recommendations, achieved 100% score. Improved 23% then 37% over past quarter.

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