How Yana Health Reduced Denials by 28% and Took Control of Their Revenue
Yana Health reduced its denial rate from 18% to 12.2%, recovered approximately $11,500 in additional revenue per month, and reclaimed 50+ staff hours previously lost to manual portal work, all within two months.
"We were working very hard but still losing money. Now I feel much more in control of our revenue."
— Dr. Priya Singh, Radiologist & Owner, Yana Health (Bangalore)
Executive Summary
Yana Health is a Bangalore-based diagnostic clinic founded by Dr. Priya Singh (MBBS, DMRD, DNB – Radiology). The clinic processes roughly 800 insurance claims per month, with 40–70% of revenue coming from private and government payers.
Before implementing INCERTO:
- Denial rate averaged 17.5%
- Days in A/R stood at 45 days
- ~63 staff hours per month were spent on manual payer portal work
- Appeals were inconsistent and tracked in spreadsheets
Two months after implementation:
- Denial rate reduced to 12.6% (28% relative reduction)
- ~$11,500 additional net revenue recovered per month
- Days in A/R reduced from 45 to 38
- ~47 staff hours per month freed from portal monitoring
- First measurable improvement appeared after week four
About Yana Health
Yana Health is an independent diagnostic clinic in Bangalore performing MRI, CT, ultrasound, and X-ray services.
Billing is handled in-house by a small administrative team using a standard billing platform. However, payer interaction required logging into:
- 3 private insurer portals
- 2 government scheme portals
- The internal billing system
The government portals in particular required manual document uploads and daily status checks.
For a 12-person clinic, this workload was manageable — until denial patterns began repeating.
A Revenue Problem With No Clear Diagnosis
By the time Dr. Singh began looking for answers, the denial rate had stabilized around 17.5%.
At 800 claims per month, that meant roughly 140 denied claims monthly.
Many were eventually corrected. But about 60% required rework, resubmission, or appeal.
"It wasn't that everything was broken. But every single day there was something. A rejection here, an underpayment there. We were constantly checking portals."
The deeper frustration wasn't just denials. It was lack of visibility.
- No consolidated view by payer
- No CPT-level pattern tracking
- No recurring modifier analysis
- No structured appeal follow-up process
One specific issue later uncovered:
Repeated denials for contrast-enhanced MRI studies under a government scheme. The denial reason code cited "incomplete documentation," but the actual issue was a missing header field required in that scheme's upload format.
The financial picture was just as troubling. Days in A/R had climbed to 47 days. Underpayments were often discovered months after the fact. Appeals happened inconsistently, triggered by whoever had bandwidth rather than by any structured process.
"As an owner, I felt we were working very hard but still losing money. I realized this simply wasn't sustainable."
— Dr. Priya
Building a System That Could See the Patterns
Yana Health implemented INCERTO as an AI-driven revenue execution layer: not a reporting dashboard, but a system that actively operates across billing platforms and payer portals around the clock.
Rather than surfacing data after the fact, INCERTO deployed AI agents to continuously monitor claims, identify denial patterns in real time, flag recurring root causes, and structure payer response trends. Over time, the system built an evolving picture of the clinic's revenue behavior: which denial codes appeared by payer, how often specific CPT codes were flagged, where documentation deficiencies kept surfacing, how long appeals took and how often they succeeded.
The shift this enabled was fundamental. Yana Health moved from handling each claim as a one-off event to operating with pattern-level visibility across their entire billing workflow.
The Results
Denial Rate Fell by 32%
Within two months, Yana Health's denial rate dropped from 18% to 12.2%. The root causes that had been invisible in the spreadsheet era (authorization gaps, modifier errors, repeated documentation omissions) became identifiable and fixable.
"Now we can actually see denial patterns very clearly. We can fix the root cause instead of constantly reacting."
— Dr. Priya
Collections Rose by 18%
With fewer denials reaching the rework stage and appeals being handled more consistently, net collections climbed 18%. The estimated financial impact was approximately $38,000 in additional protected or recovered revenue each month, with appeal turnaround time improving by 26%.
Days in A/R Dropped from 47 to 37
A 21% reduction in Days in A/R translated directly into more predictable cash flow, less revenue aging beyond 90 days, and a more stable working capital position for a clinic that had previously found long-term revenue planning difficult.
Portal Work Dropped by 60%
The reduction in manual portal work freed roughly 50 staff hours per month, time that has since been redirected toward pre-authorization accuracy, patient coordination, and upfront documentation improvement.
"We are not bouncing between 5 different portals anymore. My staff can now focus on patients instead of admin work and the paperwork."
— Dr. Priya
What Really Changed
The numbers matter. But for Dr. Priya, the more meaningful shift was one that doesn't show up directly in a metric: the feeling of being in control.
Before INCERTO, revenue felt unpredictable. Denials came as surprises. Decisions were made reactively, under pressure, with incomplete information. After implementation, patterns surfaced early enough to act on. The team had a shared, reliable picture of where revenue was at risk and what to do about it.
"We were constantly reacting. Now we can see clearly, fix the root causes, and I feel much more in control."
— Dr. Priya
For a 12-person clinic where the owner is also a practicing physician, that kind of control represents something genuinely transformative, not just operationally, but in terms of what it's possible to build.
What Comes Next
With a stabilized denial rate and a billing team no longer consumed by repetitive portal tasks, Dr. Priya is turning her attention to growth. The practice is evaluating an expanded service line in advanced diagnostics, and with revenue now predictable enough to plan against, the financial groundwork for that expansion is in place for the first time. The goal isn't just a more efficient clinic; it's a more sustainable one, built on revenue infrastructure that scales as the practice does.