Case Study: How a Multi-State ABA Clinic Fixed Its Billing Struggles by Replacing Its RCM Vendor with Problem Solvers
“From day one, Camber wasn’t just another vendor—they were part of our team. They understood our problems, worked side-by-side with us, and helped us build a system that actually works.”
– Alex, CEO of Lacuna Autism Services
The Big Picture
By teaming up with Camber, Lacuna Autism Services didn’t just boost collections from 70% to 95% within only 2 months of implementation—they also built a transparent, collaborative, and automated insurance billing system that actually works.
Why Lacuna Autism Services Needed a Change
Lacuna Autism Services started in Las Vegas with a simple but ambitious goal: bring high-quality ABA therapy to communities that need it most. Fast forward a few years, and Lacuna now serves over 300 patients across Nevada, Colorado, Tennessee, and Texas. But with growth came the headaches of dealing with higher and higher volumes of insurance reimbursement.
Alex, CEO, had been through this before, having grown another ABA clinic from 1 to 17 locations. He knew how crucial it was to get billing right in order to bring the highest quality of care to the communities his clinics served. Despite his experience, Lacuna was running into the same problems over and over again. Billing inefficiencies were slowing down payments, cash flow was unpredictable, and keeping up with the constant insurance hurdles was becoming a full-time job in itself.
Alex and his team needed a fix—and fast. Enter Camber.
Challenge #1: Moving from a Vendor to a Strategic Partner
Recurring Issues with Previous Vendors
Lacuna worked with multiple billing vendors, each promising better results but failing to deliver a lasting solution. One vendor reduced costs but left collections at just 40%. Another improved collections to 70%, but improvements plateaued, and the Lacuna team was constantly troubleshooting. Their billing meetings often focused on fixing immediate issues rather than identifying systemic problems, leaving the team without clear ownership over long-term improvements.
Adding to the frustration, denied claims were rarely investigated and prior authorization issues were mismanaged, forcing Lacuna to navigate constant delays and resubmissions. Furthermore, past vendors operated reactively, providing no proactive guidance to prevent problems before they escalated.
On the other hand, we at Camber consider a strong collection rate to be 95% or higher and structure our approach around achieving and sustaining that benchmark.
Approaching Camber with Caution
After previous billing vendors failed to deliver long-term improvements, Lacuna approached us with caution. The concern wasn’t just about whether our system worked—it was whether we would take real ownership of solving problems rather than offering surface-level fixes.
Our partnership approach focuses less on quick adjustments, and more on the root causes of billing inefficiencies. Unlike past vendors who operated independently, we take a more collaborative approach, working directly with Lacuna’s leadership to ensure any proposed changes align with their operational and clinical requirements.
An example of this stemmed from a learning we surfaced during the implementation process: Lacuna and team were hand-editing claims to select the correct modifier for the service and payer. The opportunity became clear – we would partner to reduce both time-spent and potential for error. We created validation rules based on our database of millions of claims for their payer set, as well as a diagnostic of Lacuna’s historic data.
A Shift Toward Long-Term Solutions
Over time, the way Lacuna managed their billing processes shifted. Instead of reacting to issues after they occurred, the focus shifted to preventing them in the first place through our task management system and real-time dashboards, which provided visibility into potential issues before they became critical.
By making billing more transparent and structured, Lacuna was able to move from a cycle of constant corrections to a more predictable, data-driven approach. The goal wasn’t just to fix the problems they were facing but to create a process that could scale with the growth.
“Every single time we came to the table, every single week, it wasn’t, ‘Hey, you guys need to do this. Hey, you guys need to do that.’ It was like, ‘Here’s the problem identified. Here’s three solutions. Do you guys have any other ideas?’” – Alex, CEO of Lacuna Autism Services
Challenge #2: Making Billing Transparent and Predictable
Camber’s Fix: Smart Automation and Instant Insights
We demonstrated our commitment to a true partnership early on by conducting an in-depth diagnostic of Lacuna’s revenue cycle within 72 hours. We uncovered critical inefficiencies, including errors in split billing, missing denial patterns, and overlooked claims. Rather than simply presenting findings, we provided a clear, actionable plan to address these issues, reinforcing a hands-on, problem-solving approach before going live.
With real-time claims tracking Lacuna could see exactly where revenue was getting lost. Our automation tools didn’t just clean up claims—they prevented denials before they even happened. And with a smart task management system, the team could now tackle issues before they spiraled into bigger problems.
“In that moment, I was like, ‘okay, the amount of information they came back with was essentially the three years of struggling that we’ve been going through, and they provided a solution.’” – Alex, CEO of Lacuna Autism Services
The impact was immediate: a 3x improvement in collections, a 95%+ clean claim rate on first pass, and recognition as Nevada’s #1 Medicaid provider for billing accuracy.
With this infrastructure and insight in place, Lacuna could finally shift its focus away from revenue cycle issues and back to its core mission: providing high-quality ABA therapy. The newfound financial stability allowed them to expand their services, open new locations, and impact more families across the country.
What’s Next for Lacuna?
Now that Lacuna’s billing is running smoothly, the focus is on expansion. With our trusted partnership, they’re exploring multidisciplinary services like PT, OT, and speech therapy—without worrying about revenue bottlenecks.
By mid-2024, Anthem recognized Lacuna as the #1 Medicaid provider in the state of Nevada, awarding them a sizable reimbursement check for their operational improvements. With us in their corner, Lacuna is primed for sustainable, scalable growth.
“It wasn’t a package—it was, ‘Let’s go solve these problems together,’ and that’s what’s evolved over time.” – Alex, CEO of Lacuna Autism Services
--
