Case study

$32,000/month recovered in 30 days at Lakeside Family Medicine.

A 4-provider independent family practice in the Pacific Northwest plugged HIMShield into their athenahealth instance on a Tuesday morning. By Friday, the first compliance alerts were live. Inside 30 days, the Revenue Leakage Report quantified $32K/month in recoverable HCC and E&M revenue.

$32,000
monthly revenue recovered
91/100
documentation quality score
30 days
to first full report

The challenge

Lakeside is exactly the kind of practice that gets squeezed hardest by documentation drift: physician-owned, four full-time providers, one billing administrator, and zero room to hire a dedicated HIM team. Denials were creeping up. E&M codes were getting downgraded by payers. And nobody on staff had time to chase HCC specificity in the chart.

What HIMShield did

  • Connected to athenahealth in 3 hours via read-only FHIR API. No IT vendor involved.
  • Scanned 14 months of charts and flagged HCC, E&M, medical necessity, and J-code gaps by provider.
  • ARIA drafted corrections for one-click physician e-signature, collapsing the query cycle from 72 hours to under 2.
  • Delivered a per-provider Revenue Leakage Report on day 30 — with dollar figures attached to every gap type.

The results

  • $32,000/month in recovered revenue, sustained over the following quarter.
  • Documentation Quality Score climbed from 67 to 91 in 90 days.
  • Denial rate dropped 41%; average days-in-AR shortened by 9 days.
  • Zero additional FTEs hired.

"HIMShield found $32,000 a month in HCC and E&M revenue we were leaving on the table — in 30 days. As an independent practice, this is infrastructure I could never have built myself."

Dr. Sarah Jenkins, physician-owner of Lakeside Family Medicine
Dr. Sarah Jenkins, MD
Physician-Owner, Lakeside Family Medicine

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