Case Study: How a multi-location mental health practice closed the gap insurance was hiding 

The Problem Nobody Was Watching 

When Myriad Systems took over billing and payment operations for a large, multi-location mental health practice in April, the practice looked financially healthy on the surface. Claims were getting paid. Revenue was coming in. 

But one number told a different story: insurance payments were running at over 14 times the dollar amount of patient payments in April ($206,940.55 in insurance payments against just $14,481.82 in patient payments). Industry benchmark is 1.5–3x, depending on payer mix and specialty. 

That ratio is a warning sign, not a footnote. It meant the practice was collecting from payers just fine — and losing the other side of the equation almost entirely. 

Digging in confirmed it. Only 10–20% of patients were paying their copay before treatment. Deductibles and coinsurance were, for practical purposes, not being collected up front at all. Patient accounts receivable had climbed past $1.3 million and was still growing. 

For a practice with a large and sometimes volatile patient base, that wasn't a small operational gap — it was a structural cash flow problem hiding behind healthy-looking claims data. 

The Fix 

The practice implemented Myriad's Healthcare Payment Program, which changed how — and when — patients were asked to pay: 

• New check-in messaging, rewritten to set clear payment expectations before the visit 

• New card-on-file requirements and caps, replacing an ad hoc, inconsistent policy 

• Upfront cost estimation on every appointment, so patients knew what they owed before treatment instead of after 

None of this was a small ask. Practice leadership was understandably cautious about changing policy with a large, sometimes sensitive patient population — but moved forward, and the program went live. 

The Results 

Patient payments climbed every single month after rollout: 

From April to July, patient payments grew 779% — from $14,481.82 to $127,296.08 per month. 

The insurance-to-patient ratio tells the same story from a different angle: it dropped from 14.3x in April to 3.5x by July — landing right at the edge of the healthy 1.5–3x industry benchmark, down from a starting point nearly five times outside it. 

Annualized, that shift represents more than $1.4 million per year flowing back to the practice — revenue it was already earning, just never collecting. For most practices running a similar gap, the realistic monthly impact is in the thousands to tens of thousands of dollars, even before accounting for outliers like this one. 

The Takeaway 

Insurance payments getting collected doesn't mean a practice is financially healthy. If patient payments are a fraction of what they should be relative to insurance, that gap doesn't fix itself — it compounds, especially with high-volume or high-touch specialties like mental health. 

Myriad MediPay is built to close that gap: point-of-care estimation, compliant payment collection, and automated follow-up — so practices collect what they've already earned. 

We can prove it. 

Figures reflect a real Myriad Systems client engagement. Practice name and identifying details withheld to protect patient and business confidentiality. Monthly figures (April–July ‘26) are pulled directly from the Myriad Ecosystem platform reporting.