How Carlson ProCare handled a 3x January reverification surge while its staff were off.

Carlson ProCare Physical Therapy has five clinics across Connecticut: New Milford, Meriden, Middletown, Willimantic, and New London. Together, they have earned more than 850 five-star Google reviews with a culture built on support, motivation, and connection.

Challenge: January comes all at once

Any practice owner knows that the first week of January brings a flood of insurance work. Deductibles reset, employers may change carriers, and some policies lapse. So when the new year begins, Carlson ProCare has to reverify benefits for every active patient across all five clinics.

The hard part is that most payer portals do not publish the new plan year's benefits until the year begins. The team cannot get far ahead of the work or spread it out over the month. The new information becomes available at the same time for every active patient.

Before Shasta, Carlson ProCare's staff worked through those changes one patient at a time. They called the payer, waited on hold, and entered the result in the EMR. That meant spending New Year's Day on the phone, and the work could take weeks.

The January verification queue landed on top of the normal work of running five clinics. Carlson ProCare needed a way to get through the surge without sending the front office back into payer hold lines.

“At the beginning of every year, insurance verifications have been a big challenge for our front desk and billing teams. We used to spend HOURS on the phone trying to reach insurance payers because the information we needed for Physical Therapy benefits wasn’t always complete on their portals. Things like authorization requirements and visit limits would be difficult to track down, which added a LOT of stress during an already busy time.

We would even work on New Year’s Day to get a head start verifying benefits with government payers like Medicare. Shasta’s AI-powered insurance verification service made a HUGE difference for us. It helped us get the information we needed much more quickly, saved our team valuable time, and really reduced the anxiety that comes with the start of a new year in a healthcare practice. We greatly appreciated the support!”

This year, the work started at midnight

When the clock struck midnight on New Year's Eve, Shasta's insurance verification agent started working through the patient list. The queue was three times larger than usual.

The agent logged into payer portals, verified each patient's benefits, and updated the patient's record in the EMR. When benefits had changed or a plan was inactive, Shasta updated the insurance information and emailed the team. The front office only needed to step in when a case needed review.

All of this happened while Carlson ProCare's staff were off for the holiday.

Staff came back to the exceptions

By the time the team returned, the routine verifications were already done. Staff could open the EMR, see what had changed, and focus on the patients Shasta had flagged. They did not have to start January with the full patient list or send everyone back into payer hold queues.

The difference was in the shape of the work waiting for them. Shasta had already handled the routine cases. The team came back to plans that had changed, gone inactive, or needed a closer look. Updates and alerts were already in the EMR, so staff could see what had happened without working from a separate list.

741 verifications, 38 exceptions

Over the month, Shasta verified 741 patients. Only 38 were flagged for staff follow-up because of issues such as an inactive plan or a change in benefits. The other 703 verifications moved through without the team stepping in.

Carlson ProCare's staff stayed off for the holiday and returned to a short list of exceptions instead of weeks of payer calls. Staff only needed to follow up on about 5% of the month's verification volume.