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RCM at Compass Health: How Two Staff Manage $7M in Monthly Claims

February 26, 2026
| 3.5 minute read

Sandy Washburn

Chief Operating Officer

stack of coins with arrows pointing upward representing RCM (revenue cycle management)

Over the years, I’ve witnessed firsthand the complexities of providing mental health services across a wide and diverse patient base. Compass Health Systems really lives up to its name because we really do reach out in every direction — we have nine brick-and-mortar locations and serve about 80 nursing homes and assisted living facilities across 12 states.

By its very nature, an organization this large is complex. We manage about 32,000 services monthly. Our clinical teams deliver multidisciplinary care. We have board-certified psychiatrists, nurse practitioners, psychologists, and many other healthcare professionals. We operate several specialty centers and an in-house pharmacy.

Revenue Cycle Management (RCM) for such a vast operation is no small feat. When I first took a close look at our processes, I knew we faced a massive challenge in scaling our RCM to cover all our operations.

Handling millions of dollars in claims every month usually means increasing staff and overhead, but that wasn’t a sustainable option for us. We needed a smarter solution — one that could optimize our billing workflows without sacrificing accuracy or speed.

The Complexity Behind Our Mental Health Billing

Mental health and substance abuse treatment present unique hurdles in managed care billing. Each state has different regulations, each insurer has varying requirements, and the specialties within our team require precise coding and documentation. For example, CPT codes that apply to one service might not be valid for another insurer or specialty. Add to that the need to ensure accurate tax IDs and provider overrides — and the potential for errors can multiply quickly.

Given these factors, manual billing wasn’t going to cut it. We needed medical billing software that could handle healthcare revenue optimization at scale and automate the tedious processes — the parts that humans can handle well but computers and artificial intelligence can handle much faster, flawlessly, and without getting fatigued.

That’s when we turned to eClinicalWorks RCM solutions.

Implementing a “Rule-Based” System with eClinicalWorks

Compass had been using eClinicalWorks (eCW) for about 10 years before engaging with their RCM Consulting Services. This partnership proved invaluable. Together, we implemented an impressive set of 475 specific rules within the system—leveraging the Coding Accuracy Support System (CASS)—to automate claim scrubbing right at the front end.

These rules meticulously verify that claims have the correct tax ID numbers for each state, ensure provider overrides are accurate, and confirm that CPT codes match the appropriate insurance companies and specialties before claims ever leave our system. This intense front-end precision means that claims are clean, compliant, and ready for swift processing.

Front-End Precision Means Back-End Speed

The magic of our approach is that by perfecting the front-end process—through electronic posting combined with CASS-driven claim scrubbing—the back-end payment posting becomes almost effortless. In fact, we have only two people in our payment posting department handling approximately $7 million in monthly claims. That’s right: two staff members managing what would typically require a much larger team.

This level of efficiency is only possible because of revenue cycle automation tools embedded in our RCM software solutions. Automating repetitive tasks and rule-based validation frees our staff to focus on exceptions and complex cases, rather than manual data entry or chasing down claim errors.

Why Scaling Isn’t About Hiring More Billers

One of the biggest lessons I’ve learned is that scaling your RCM isn’t just about adding more billers or increasing headcount. It’s about refining the rules and workflows that govern your system. Smart revenue management automation enables you to do more with less — handling greater volumes without sacrificing accuracy or timeliness.

Our experience at Compass has shown that investing in the right RCM software and consulting services to tailor your system’s rules and automation can transform your billing operations. We went from a potentially overwhelming, error-prone process to a streamlined, efficient workflow that supports quality patient care without ballooning overhead.

Final Thoughts

Mental health services are inherently complex to administer and bill for, especially when you’re operating in multiple states with a diverse patient population. But with the right revenue cycle management software and a strategic focus on front-end automation and rule-based claim validation, it’s possible to scale efficiently and optimize healthcare revenue.

If you’re managing a large volume of claims and looking to do more with your existing staff, I highly recommend exploring RCM software solutions that offer robust revenue cycle automation tools. For us, partnering with eClinicalWorks and leveraging their RCM Consulting Services has been a game-changer — helping Compass Health Systems continue delivering the quality care our communities depend on, while keeping our revenue cycle smooth and sustainable.

Thanks for reading — and here’s to smarter, scalable RCM!