GoHealthcare Case Study Library
Developed by GoHealthcare Practice Solutions
Explore 22 de-identified engagements across prior authorization, patient access, revenue cycle and payment integrity, compliance, payer contracting, surgery, credentialing, technology, operational transformation, and healthcare investment.
Use the search and filters to find case studies that match your specialty, operational challenge, or area of interest. Each study may appear under multiple focus areas because healthcare workflows are interconnected.
Case Study Navigation
Search by procedure, operational challenge, specialty, organization type, payer issue, or business need. Select a focus area to narrow the library.
22 case studies
Showing all published case studies
Case Study 01
Florida-based pain and orthopedic practice
GoHealthcare took ownership of complex prior authorization, utilization management, surgical coordination, scheduling, workers’ compensation workflows, and patient access support.
Case Study 02
Kansas-based high-volume pain management practice
A focused recovery engagement prioritized stalled cases, corrected incomplete requests, coordinated payer follow-up, and introduced organized tracking while new requests continued.
Case Study 03
Texas organization with five clinics and one ASC
GoHealthcare connected authorization, medical necessity, documentation, billing, follow-up, and performance visibility across multiple clinics and an ambulatory surgery center.
Case Study 04
Nevada healthcare practice with growing administrative demand
The engagement established responsible AI guardrails and introduced a custom agent supporting patient access and revenue cycle workflows while retaining human review and oversight.
Case Study 05
Multi-specialty practice with a complex payer mix
A comprehensive engagement reviewed the full revenue cycle, coding and documentation risk, compliance exposure, denial trends, reimbursement performance, and payer strategy.
Case Study 06
Specialty pain and neuromodulation practice
GoHealthcare redesigned the spinal cord stimulation authorization workflow around case readiness, payer-specific criteria, documentation integrity, proactive follow-up, and scheduling handoffs.
Case Study 07
Specialty practice with an affiliated ambulatory surgery center
Professional and facility revenue cycles were connected through shared authorization controls, charge reconciliation, coordinated denial analysis, payment review, and unified reporting.
Case Study 08
Specialty pain and spine practice
The team addressed existing denials and future approval readiness with payer-policy reviews, medical-necessity gap analysis, procedure-specific checklists, appeal preparation, and pre-submission quality assurance.
Case Study 09
Specialty pain and musculoskeletal practice
A centralized operating model connected treatment authorization, documentation, adjuster and attorney coordination, billing, accounts receivable, fee-schedule review, disputes, and case reporting.
Case Study 10
Specialty surgical practice managing a complex case
GoHealthcare coordinated network-gap evidence, medical-necessity review, payer escalation, an exception pathway, financial readiness, professional and facility alignment, and claim preparation.
Case Study 11
Independent physician practice with a lean team
The patient-access workflow was redesigned from appointment request through encounter readiness and billing handoff, including registration, eligibility, referrals, authorization, communication, and schedule recovery.
Case Study 12
Independent interventional pain management practice
A structured remediation program combined chart audits, coding and modifier review, documentation templates, provider education, pre-bill quality assurance, corrective actions, and ongoing monitoring.
Case Study 13
Multi-location pain, MSK, and orthopedic organization
GoHealthcare standardized and centralized intake, eligibility, authorization, scheduling, work queues, quality assurance, productivity management, reporting, and capacity planning across locations.
Case Study 14
High-volume, multi-location musculoskeletal specialty practice
GoHealthcare interpreted new medical-necessity criteria, managed a vendor and portal transition, identified procedures at risk, redesigned payer-specific workflows, and established ongoing policy monitoring.
Case Study 15
Multi-specialty physician organization
GoHealthcare evaluated the complete operating environment, stabilized daily operations, reduced authorization and billing backlogs, improved denial and accounts-receivable performance, and established sustainable governance.
Case Study 16
Orthopedic, spine, neurosurgical, and ASC-based surgical organization
The surgical coordination process was redesigned from physician decision through authorization, facility and financial clearance, preoperative readiness, procedure completion, charge capture, and billing handoff.
Case Study 17
Physician practice dispensing off-the-shelf spinal orthoses
A focused DMEPOS audit reviewed POS 11 versus POS 12, HCPCS selection, medical necessity, orders, proof of delivery, supplier documentation, claim correction, and sustainable pre-bill controls.
Case Study 18
Growing multi-specialty organization with expanding providers and locations
GoHealthcare resolved outstanding applications, standardized provider files, improved enrollment accuracy, strengthened payer contracting, protected effective dates, and established participation governance.
Case Study 19
Multi-specialty organization with complex payer contracts
GoHealthcare reconstructed contract payment rules, identified systematic underpayments, pursued valid recovery, corrected payer configuration defects, and established continuous payment-compliance monitoring.
Case Study 20
Specialty physician organization treating injury-related cases
GoHealthcare consolidated medical lien accounts, verified attorney and case information, tracked matters through settlement, governed reduction requests, reconciled payments, and established a dedicated lien revenue-cycle model.
Case Study 21
Private equity investor evaluating a multi-location physician practice platform
GoHealthcare performed operational due diligence, transaction support, closing-readiness planning, and post-close value-creation advisory across revenue cycle, payer infrastructure, credentialing, compliance, staffing, technology, and governance.
Case Study 22
Multi-provider interventional pain management and musculoskeletal practice
GoHealthcare designed and implemented integrated Chronic Care Management, Remote Therapeutic Monitoring, and Remote Patient Monitoring programs supported by standardized workflows, compliance controls, revenue cycle integration, technology, and operational governance.
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GoHealthcare Practice Solutions supports physician practices, ambulatory surgery centers, healthcare platforms, and investors across patient access, prior authorization, surgical coordination, revenue cycle and payment integrity, compliance, credentialing, payer contracting, operational transformation, technology, and value-creation advisory.
Developed by
MSc, BSc, CRCR, CSAPM, CSPPM, CSBI, CSPR, CSAF, Certified in Healthcare A.I. Governance
Founder and Chief Executive Officer of GoHealthcare Practice Solutions
This content is provided by GoHealthcare Consulting and Business Development LLC, doing business as GoHealthcare Practice Solutions, LLC, for general professional, operational, educational, and informational purposes only. It is not medical, legal, regulatory, compliance, coding, billing, reimbursement, financial, or payer-specific advice and does not establish a consultant-client, attorney-client, provider-patient, or other professional relationship.
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