Stats for this case study
461K
230K
58K
40%
Katie Fergus, CEO
PractiSynergy
Challenge
After acquiring a small billing company in 2017, Fergus inherited paper-based workflows, an outdated DOS system, and limited visibility into claims performance. Scaling the business—and earning client trust—required moving to a cloud-based platform with automation, analytics, and real-time reporting.
Solution
PractiSynergy selected Tebra Billing as its centralized, cloud-based platform and redesigned workflows around automation and denial trend analysis. By consolidating charge entry, payment posting, reporting, and denial management into one system, the team reduced manual work while increasing insight and control.
Results
With Tebra, PractiSynergy grew from 26 to 100 practices while automating roughly 40% of its workflows. For a billing company operating at similar scale, total hidden costs avoided and revenue recovered are estimated at $749K annually.
Getting started
Katie Fergus didn’t start her career in healthcare billing. As a CPA working inside a pediatric nonprofit, she watched staff struggle with secondary insurance and Medicare claims—not because they lacked effort, but because no one had built a process to manage reimbursement at scale. Fergus stepped in, built the workflows herself, and became deeply interested in how revenue cycle management could make or break a healthcare organization.
That experience led her to acquire a small medical billing company which she later renamed PractiSynergy. What she bought, however, came with immediate reality checks. A significant portion of inherited clients had already churned, cashflow was unpredictable, and the business relied on paper files and an antiquated DOS-based system.
Putting technology first
Fergus knew quickly that incremental fixes wouldn’t work. To scale, the business needed a cloud-based foundation where staff and clients could see claim status, reimbursement progress, and performance indicators in real time. As a finance leader, transparency and analytics were non-negotiable.
In 2019, Fergus partnered with Kevin Babb, a former surgical RN with deep operational experience, to rebuild PractiSynergy’s internal processes. Together, they evaluated technology options using a structured scorecard across cost, workflow design, analytics, and reporting.
“When I evaluated technology options, I had a scorecard rating cost, process, procedure, analytics, and reporting. Tebra was the best fit for where we needed to go,” said Fergus.
Tebra’s billing solution became the backbone of PractiSynergy’s operations. Charges were centralized into one system, insurance and patient payments were automated through Robotic Process Automation (RPA), and denial codes were standardized so staff could work issues in batches rather than one-by-one.
Shifting trust and time
The shift dramatically changed how the company communicated with clients. Previously, monthly reports were thick, manual, and difficult to interpret. With Tebra dashboards, clients could access performance data on demand—building trust while reducing ad hoc reporting requests.
“As a billing company, we control our clients’ cashflow,” adds Fergus. “To earn and keep their trust, we needed to make that information easy to understand.”
Partnering for a pivot
PractiSynergy’s growth accelerated just as the healthcare industry faced disruption from COVID. Many of their clients were classified as non-essential specialty practices, while a new wave of startups emerged from provider burnout within hospital systems.
Through Tebra’s Partner Connect program, PractiSynergy found new clients at a critical moment—allowing the company to grow instead of contract. They also found a customer “sweet spot:” startups. Working with healthcare providers who were launching their own private practices, and wanted to streamline backoffice operations from the beginning so that they could focus on patient care, became a game changer for PractiSynergy. It put them in a position to become a trusted partner for growth.
Automating for insight and scale
Today, roughly 40% of PractiSynergy’s workflows are automated. More importantly, the team has shifted effort away from data entry and toward denial analysis, root-cause resolution, and proactive client education.
“Denials are where practices lose money without realizing it,” said Fergus. “Once we could see trends, we could fix problems instead of reacting to them.”
Supporting a passion for more choice
Katie Fergus and Kevin Babb are not only laser focused on day-in and day-out predictability in cashflow, they’ve got their eyes on a longer game and broader vision.
“In the next few years, I truly see us as supporting independent medical practices and helping build the healthcare industry into a stronger environment so that patients like you and I have a choice of where we go. And the only way our independent medical practices can survive is if they deliver excellent care and have reliable cashflow and Revenue Cycle Management. That is what we are here to do.”
Babb adds: “Doctors, PAs and Nurse practitioners can come into the private sector, and set up their own successful practice if they have the right building blocks. And they can practice with less stress, less headaches, less time spent doing paperwork. It’s a very emotional thing. Building a small business is so hard. But the rewards are tremendous. And we are so passionate about being part of that.”
The work that PractiSynergy does with Tebra doesn’t eliminate hours, but instead redeploys them from clerical work into denial recovery, root-cause fixes, and revenue protection. This frees up their team —and the healthcare practices they support —to do more of the work that they love, delivering more choices for healthcare.
*Hidden Costs. Calculation Assumptions:
- Blended AR operations rate (data entry, AR specialists, owner oversight): $32/hour
- Scale context: ~100 small / independent healthcare practices
| Hidden Cost Area | Hours Assumed per Practice | Source of Assumption | Total Annual Hours | Cost Impact |
| Denial Resolution & Revenue Recovery | ~12 hrs / month | ~100–130 denials per practice per month × ~6–8 minutes each when worked in batches using RPA and denial code categorization | ~14,400 hrs | $460,800 |
| Payment Posting & Charge Entry | ~6 hrs / month | Automated insurance and patient payment posting plus centralized charge intake via Tebra RPA | ~7,200 hrs | $230,400 |
| Reporting, Audits & Client Visibility | ~1.5 hrs / month | Real-time dashboards and self-serve reporting reduce manual report prep and ad hoc client requests | ~1,800 hrs | $57,600 |
| Total Hidden Costs Reclaimed | ~19.5 hrs / month | Automation + denial trend analysis at scale | ~23,400 hrs | $748,800 / year |
Products used in this case study
Insights for independent healthcare practices
