From revenue cycle strain to
faster cash and cleaner work queues
A large DME provider moved from managing revenue cycle entirely in-house — under recruiting, training and retention pressure — to a controlled revenue rhythm with faster cash flow and cleaner
work queues.
Durable Medical Equipment
Revenue Cycle Management
0 wk
Billing live within one week
~0%
Operating cost reduction
0%
Accounts receivable reduction
The journey
From revenue strain to results
How this provider moved from revenue cycle pressure to faster cash and cleaner work queues — the challenge they faced, what was at stake, the partnership that turned it around, and the results that followed.
The provider was managing RCM entirely in-house. When recruiting and retention failed, the backlog didn’t just grow — it started threatening the referral relationships that drove new business.
Recruiting failure
The internal RCM model broke
The provider ran revenue cycle internally while struggling to recruit experienced help and retain staff long enough to train them. The model became unsustainable.
Backlog & denials
The work queue compounded
The backlog grew. Denials demanded more attention. Documentation retrieval got harder. Each week of delay added to the pile rather than resolving it.
Referral risk
Growth itself was under threat
Referral relationships were increasingly at risk — the downstream cost of operational failure that reached well beyond the revenue cycle itself
02 · What was at stake
Where the revenue cycle was straining
The provider’s revenue cycle ran across interconnected functions. Each one had a specific breakdown — and each breakdown compounded the next.
Verification
Orders not verified on arrival.
Authorization
Workflows deprioritized; delivery at risk.
Billing
Claims not filed promptly at delivery.
Compliance docs
Documentation misaligned with payers.
Denials
Backlog accumulating; no clear path.
Each breakdown compounded the next: unverified orders delayed authorizations, delayed authorizations slowed billing, slow billing inflated AR — and growing AR consumed the very staff capacity needed to work denials.
03 · The partnership
Knack took ownership of revenue cycle operations
The intervention was a rapid onboarding of specialist capacity, embedded directly into the provider’s workflow — not a generic, hands-off engagement.
Rapid onboarding
Structure from day one
Knack quickly onboarded the engagement and brought structure to the workstream. KPIs were established — and met — from the start.
Embedded execution
Inside the workflow, not alongside it
Orders were verified as they arrived and claims were billed as soon as delivery was complete. Knack worked inside the provider’s workflow — not beside it.
Compliance support
Aligned to payer requirements
Documentation guidance kept billing aligned with payer requirements — reducing avoidable risk across the supported workstream.
What changed: the provider moved out of survival mode. Internal teams were freed to focus on new business and on servicing the accounts they already had.
04 · The results
The outcomes
With the pressure understood and the intervention in place, the outcomes speak plainly. Every figure below is sourced directly from the engagement.
Billing in one week
Billing started within one week of engagement commencement.
~30% lower operating cost
Operating cost reduction across the supported workstream.
50% AR reduction
Accounts receivable cut by half across the cycle.
Teams refocused on growth
Internal staff redeployed from survival-mode RCM to growth and account servicing.
Your DME journey
See how your DME revenue compares
Share a few high-level metrics and we’ll show you where specialty-intelligent, AI-enabled RCM can move the numbers — verification, authorization, billing and denials.