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Medical Billing Case Study

How QuestNS Created a $1.25M Net Revenue Impact for One Medical Practice

A medical practice struggling with aging accounts, delayed claims, and a 63% collection rate partnered with QuestNS to strengthen its revenue cycle. Over 22 months, the practice increased collections, generated additional revenue, and significantly improved monthly payments.

  • $1.68M+ Additional Revenue
  • +$76,592 Avg. Monthly Payments
  • 63% → 69% Collection Rate
  • $1.25M Net Revenue Impact

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Let’s start with the results

The Results

Before partnering with Quest National Services, the practice was generating approximately $5.8 million annually while aging accounts and delayed submissions contributed to a 63% collection rate. Quest was brought in to improve collections, streamline the revenue cycle, and increase net profit.

$1,685,025.83 in additional revenue

$1.25M in Net Financial Impact

Across the 22-month period, the practice generated $1,685,025.83 in additional income compared with its pre-Quest baseline. After $435,715.30 in Quest service expenses, the practice realized a net financial impact of $1,249,310.53.

REVENUE CHART
15.65% Increase in Total Payments

+$76,592 average per month

15.65% Increase in Total Payments

Average total monthly payments increased from $489,271.95 before Quest to $565,864.03 after Quest – an average gain of $76,592.08 per month.

The strongest improvement came from insurance payments, which increased 20.74%, while patient payments decreased 4.23%.

Collection performance

Collection Rate Improved from 63% to 69%

Average monthly charges increased by 4.40%, from $813,418.34 to $849,215.55. During the same period, total payments increased 15.65%, helping lift the practice’s average collection rate by six percentage points.

Collection Rate Improved from 63% to 69%

Could stronger revenue cycle performance make a measurable difference for your practice?

See how Quest National Services can support billing, collections, payment posting, denial management, and accounts receivable.

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Behind the results

How Quest Supported the Revenue Cycle

The financial gains were supported by hands-on revenue cycle work across payment posting, payer follow-up, denial management, accounts receivable, and reporting.

Medical Billing

Where we started

Aging Accounts, Delayed Submissions, and a 63% Collection Rate

Prior to the partnership, the practice was generating approximately $5.8 million annually. Aging accounts and delayed submissions were limiting collections, creating an opportunity to improve the revenue cycle and recover more of the revenue already being billed.

Improving payer-side collections

20.74% Growth in Average Insurance Payments

Average insurance payments increased from $366,532.40 to $442,560.63 per month – an improvement of $76,028.23. This represented the largest component of the practice’s overall payment growth.

Medical Revenue

After the Athena transition

The Software Changed. The Work Didn’t Disappear.

After the practice transitioned to Athena, Quest continued performing extensive manual work required to move payments and claims through the revenue cycle.

This included retrieving and posting EOBs, handling virtual credit cards, posting unapplied patient payments, locating missing EOBs, checking payment status, and supplying payment documentation to Athena.

More than half of posted insurance payments

Quest Supplied 55%-56% of Payment Documentation in Two Consecutive Months

In June 2025, $539,280.27 in insurance payments were posted. Quest supplied $294,757.76 of the payments and supporting EOB information for Athena to post – 55% of the month’s total.

In July 2025, Quest supplied $264,101.61 of $469,725.06 in posted insurance payments – 56% of the month’s total. According to the case study, without this work the associated claims would have remained in an unpaid status.

After the Athena transition
A/R MANAGEMENT

Accounts receivable management

Persistent Follow-Up on High-Value and Aging Accounts

Quest managed appeals, payer portal research, live payer calls, medical-record submissions, and ongoing A/R review. The internal A/R report was updated twice per month and prioritized according to aging, dollar value, and client needs.

The case study notes that payer calls can require one to two hours because of hold times, transfers, and limits on how many claims can be discussed during a single call.

Visibility and accountability

Regular Reporting Kept the Practice Informed

Quest provided regular and as-needed meetings, weekly referral and client-assist reporting, and customized month-end reports. Reporting included charges and payments by provider and system, along with detailed Xolair reporting by provider, units, CPT, charges, and payments.

QuestNA Report
J-CODE COMPARISON

J-code collections

Tracking Performance Through a Major System Transition

For J-codes, the case study reports a 79% collection rate for January 2024 through March 2025 while the practice was working through eClinicalWorks. For March through August 2025 following the transition to Athena, the reported J-code collection rate was 58%.

The case study does not establish the software transition as the cause of the change. Instead, it documents the additional manual payment posting and follow-up work Quest continued to perform after Athena took over.

The in-house alternative

Estimated Minimum Annual Savings of $72,369

The case study estimates that replacing Quest’s current staffing with five in-house resources at an average wage of $25 per hour would cost approximately $24,000 per month including benefits.

Quest’s average monthly cost was reported at $17,969, producing an estimated minimum annual savings of $72,369 compared with that in-house staffing model.

Collection Rate Improved from 63% to 69%

Billing software can process claims. Revenue cycle performance still requires follow-through.

Quest National Services supports the hands-on work required to turn submitted claims into collected revenue.

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Have a few questions?

Case Study FAQs

How long does this case study cover?

The primary results cover 22 months of work with Quest National Services, compared with the practice’s eight-month average before switching to Quest.

How much additional revenue did the practice generate?

The case study reports $1,685,025.83 in additional income generated during the 22-month period compared with the pre-Quest baseline.

What was the net financial impact after Quest’s fees?

After $435,715.30 in Quest service expenses, the reported net financial impact was $1,249,310.53.

How did average monthly payments change?

Average total monthly payments increased from $489,271.95 before Quest to $565,864.03 after Quest, an average increase of $76,592.08 per month.

What happened to the collection rate?

The practice’s average collection rate increased from 63% before Quest to 69% after Quest.

What work did Quest continue to perform after the move to Athena?

Quest continued retrieving and manually posting EOBs, handling payment documentation, processing virtual credit cards, posting unapplied patient payments, following up with payers, managing denials and appeals, and working accounts receivable.

How much of the posted insurance payment activity did Quest support after the Athena transition?

In June 2025, Quest supplied payment documentation representing 55% of insurance payments posted for the month. In July 2025, the figure was 56%.

How did Quest compare with building an equivalent in-house team?

The case study estimates an in-house cost of approximately $24,000 per month to replace Quest’s current staff, compared with an average Quest cost of $17,969 per month. The stated minimum annual savings is $72,369.

The bottom line

More Revenue. Stronger Collections. Measurable Net Value.

Over 22 months, the practice generated $1,685,025.83 in additional revenue compared with its pre-Quest baseline. After Quest’s service costs, the reported net increase in value was $1,249,310.53.

Moving forward, the case study states that J-codes will be carved out for future billing at a reduced fee, lowering the cost to 1% of collections and saving the practice approximately $1,300 per month in Quest billing.

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