Cleaner Claims, Faster Payments, Smarter Growth: South Florida Psychiatry’s End-to-End RCM Success

As a startup, the South Florida Psychiatry team made an early decision that would shape their trajectory; they would keep billing in-house instead of outsourcing it.

“We didn’t want to rely on an outside company to manage our claims,” Sarduy explained. “We wanted to stay close to the process, but we didn’t have the structure to do it efficiently.”

The early approach of submitting paper claims, manually tracking reimbursements, and reviewing denials wasn’t sustainable, especially as patient demand began to grow.

“Inovalon brought the organization we needed,” he said. “The software gave us visibility into everything — remittances, rejections, coding errors. We were able to do it all ourselves, accurately and efficiently.”

An important part of Inovalon’s value-add was seamless compatibility with the practice’s electronic health record system, ICANotes. “That integration was critical,” Sarduy noted.

Easy interoperability has allowed the team to maintain clinical workflows without disruption, while staying tightly aligned on financial operations.

In the beginning, the practice processed just a handful of claims per week. But growth came quickly. Today, South Florida Psychiatry sees over 4,000 active clients and processes more than 1,500 claims per month. It’s a volume that would have been impossible without the right infrastructure in place.

As they grew, the practice leveraged Inovalon’s scalable solutions to unlock the automation and batch processing power needed. They upgraded from Inovalon’s Eligibility Verification™ to Eligibility Verification Pro™  — and from Claims Management™ to Claims Management Pro™.

While doing individual eligibility checks worked when the organization was small, the ability to evolve processes as their business grew saved considerable time and propelled them forward.

“Now we run batch eligibility checks on a monthly basis,” Sarduy said. “Inovalon helped us outgrow being able to check coverage one by one.”

Automation also helped the staff increase accuracy and efficiency with the implementation of customized business rules within the organization’s claims workflows. “Setting up business rules was a game changer in managing complexity as we added patients and insurance plans,” Sarduy said. Instead of the staff manually fixing common errors claim by claim, the system now flags and corrects them automatically, which saves even more staff time and reduces mistakes.

This proactive approach to eligibility has helped the team avoid one of the most painful pitfalls in healthcare finance: discovering months down the line that a patient’s coverage was inactive.

“You’d be surprised how often patients return with terminated insurance,” Sarduy explained. “If we don’t catch that upfront, we risk losing revenue for months of care. With Inovalon, we’re catching it early.”

In the last few months alone, South Florida Psychiatry has added four new providers, with more on the way. Growth at that pace could easily outstrip a practice’s internal systems, but Inovalon continues to provide the flexibility and foresight needed to scale responsibly.

“Our communication with the Inovalon team has been excellent,” Sarduy said. “We’ve looked at staffing projections together, planned for increased volume, and made sure our systems are ready. That support is invaluable.”

This proactive approach has given Sarduy a clear line of sight into the future. “Today, I have a much clearer projection of where we’ll be in the next three, six, and twelve months.”

The practice now uses monthly reporting to surface trends before they become problems. This forward-looking view gives Sarduy and his team the confidence to continue expanding access to mental health care without compromising operational control.