Heaton Eye Associates Turns Underpayment Visibility Into Action with Recovery Services

At a glance

Challenges

• Underpayment recovery was a growing area, supported by limited team capacity
• One analyst balancing contract management, fee schedules, and recovery efforts
• Manual identification and follow-up made it challenging to consistently act on every opportunity
• Leadership needed confidence that meaningful underpayments were being surfaced and addressed

Results

• $66,000 in underpayments identified through RevFind last year
• Approximately $25,000 pursued through Recovery Services
• Reduced manual effort required to prepare appeal documentation
• Recovery efforts launched without disrupting day-to-day operations

The situation

Heaton Eye Associates is a large, multi-location ophthalmology practice delivering comprehensive eye care and surgical services across its regional footprint. This engagement did not begin with a broken revenue cycle. The foundation was strong, with an experienced leadership team and a revenue cycle operation designed to keep claims moving and cash flowing across a complex payer mix.

The opportunity was in underpayment recovery. Historically, the team’s focus had been on getting claims paid and maintaining daily production. Underpayments were not ignored, but they were not being addressed systematically.

As David Colwell, Director of Revenue Cycle, explained, “With a 30-person revenue cycle department serving all locations, keeping up with the volume is the biggest challenge.” There are only so many hours in the day.

Denise Taylor, Contract Analyst, had stepped into a relatively new role supporting underpayment recovery alongside contract management, fee schedules, and other initiatives. The expertise was there, but bandwidth was limited. Underpayment recovery takes time to research, validate against contract terms, and follow up with payers.

Leadership engaged with our team to answer the question, “Are we doing this the right way, and are we missing anything?” The goal wasn’t to overhaul existing processes, but to strengthen what was already working and build confidence without adding complexity or workload.

Challenges

Manual identification is time-intensive

Underpayment recovery at Heaton Eye largely sat with one analyst supporting multiple initiatives. While the knowledge and expertise were there, time was limited. Even for experienced teams, identifying underpayments across payers, modifiers, and billing scenarios requires significant manual effort. Opportunities can exist in the data, but they are not always easy to surface consistently.

Recovery follow-through competes with daily work

Identifying an underpayment is only part of the equation. Preparing appeals, submitting claims, and managing payer follow-up takes time that directly competes with daily revenue cycle priorities.

Uncertainty in coverage

With underpayment recovery being a newer function, the team needed assurance that opportunities were being identified correctly and that nothing material was slipping through the cracks.

Outcomes

RevFind surfaces meaningful opportunities

MD Clarity’s RevFind provided the visibility Heaton Eye needed to move faster and with more confidence. The platform surfaced underpayment trends tied to specific payers and billing scenarios. Over the past year, the solution identified approximately $66,000 in underpayments and brought clarity to areas that would have otherwise required significant manual effort to uncover.

Recovery Services fills the execution gap

Once opportunities were identified, MD Clarity’s Recovery Services team helped advance a meaningful portion of those dollars into active recovery, representing approximately $25,000 in underpayment opportunities moving through appeal and follow-up. This approach allowed Heaton Eye to pursue recovery without pulling internal staff away from core responsibilities.

Marissa Bazyk, VP of Recovery Services at MD Clarity, and her team handled the heavy lift of organizing claims, preparing submissions, and initiating follow-up, while staying aligned with Heaton Eye’s billing practices and contract logic. The result was momentum without added internal strain.

Appeal Letters reduce the manual burden of recovery

As part of the engagement, the team previewed an upcoming Appeal Letters capability within RevFind. The feature pulls all required claim and patient data directly from the solution, including demographics, member details, and CPT codes, and uses that information to generate appeal letter templates.

For the Heaton Eye team, the value was immediate and practical. Denise shared that while bulk appeals are possible today, entering each appeal manually through payer portals is extremely time consuming. Automating letter creation removes one of the most repetitive and painful parts of recovery work and makes it easier to act on larger trends without adding hours of manual effort.

While this was an early preview, it reinforced how RevFind and Recovery Services work together to identify underpayments and reduce the operational friction. 

Simple execution, minimal friction 

Execution mattered to the team. Terran Smith, Associate Director of Revenue Cycle at Heaton Eye Associates, emphasized the importance of keeping things clear and efficient. Expectations were clear, the process was straightforward, and there was no unnecessary back-and-forth.

As Terran put it, “Working with the team has been easy. There’s no second guessing. Everything is straight to the point, from how it works to what we need to do. In our line of work, we don’t need 800 meetings and talk in circles.”

That simplicity made it easier for the team to engage without disrupting existing workflows or adding meetings that did not drive value.

Reinforcing best practices

The collaboration also reinforced an important principle for the internal team. As Denise noted, underpayment recovery must stay anchored to contract terms and fee schedules. By focusing on allowed amounts rather than extraneous data points, the team ensured recovery efforts stayed targeted, defensible, and aligned with how payers are contractually obligated to reimburse.

While some submissions were still pending, RevFind surfaced real opportunities, Recovery Services helped pursue them, and the team gained confidence in a scalable approach to underpayment recovery that fits their operating model.

Looking ahead

For Heaton Eye Associates, Recovery Services offer a way to extend what they have already built. RevFind brings visibility into underpayments and denials, while recovery experts help take action on the highest-value opportunities. 

MD Clarity can serve as an extension of the revenue cycle team, delivering stronger appeal outcomes, better reimbursement yield, and added support without taking time away from other priorities. 

“Working with the team has been easy. There’s no second guessing. Everything is straight to the point, from how it works to what we need to do. In our line of work, we don’t need 800 meetings and talk in circles.” - Associate Director of Revenue Cycle, Heaton Eye Associates

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