Vanguard Rheumatology

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Total Collections
Up 23% From Average

Minutes Saved
10-15 Per Clinical Encounter 

CMS/QPP Quality Score
58.8 Out Of 60

Fast Facts

Rheumatology practice
5 Providers
4 Locations
20 Staff Members


Central PM
Charts EHR for Rheumatology
Concierge RCM

Vanguard Rheumatology Case Study

Key Challenges

Complex documentation

Documentation requirements in rheumatology can be complex and time-consuming, often doubling the time it takes to see a patient. Vanguard was using a big name, remotely hosted but locally installed EHR + PM that was making that process even longer, saddled with screens that were full of checkboxes and devoid of any intuitive menus.

Staffing challenges

The challenge in hiring and managing people in the office, and the risk that those people could leave, was a continuous source of worry for Vanguard. When billing is done in-house, sick days, natural staff turnover, and the everyday challenges of managing an office often has an impact on billing.

Billing processes weren’t scaling

With increased patient volume and staffing challenges, Vanguard Rheumatology could quickly fall behind on the administrative overhead associated with each patient. It became a challenge to follow-up on claims, with A/R and FPRR ballooning. At one point, accounts receivable was over $300,000, signaling the need for change.

“For example, I see a complicated patient with scleroderma, now you’re seeing them for the first time, you want to do a very nice consult note. There are a number of standard recommendations for the diagnostic evaluation and the treatment, which would probably take 10-15 minutes to type out. I do it with just a couple of keystrokes, that’s it.”


Dr. Carlos A. Sesin, MD, Vanguard Rheumatology 

Male Doctor

Key Outcomes

Cloud-Based solution offers solid footing

The initial switch to CareCloud’s EHR + PM platform was remarkable, helping Vanguard reduce accounts receivable (A/R) from $300,000 to a manageable $10,000 and helping the practice attest to Meaningful Use Stage 1 & 2 requirements.

Customizable EHR speeds documentation

Leveraging quick text shortcuts in CareCloud Charts helps speed up the clinical encounter, helping save up to 15 minutes per patient. With everyone using the same language in their documentation, and quick texts updated regularly to reflect new data, every provider in the practice is on the same page.

Billing you can count on

Vanguard transitioned from self-billing to CareCloud Concierge RCM. Unlike employees, who may leave, take sick days and require management and benefits, Dr. Sesin knows he can rely on his account manager and the entire team at CareCloud to continue to be his experts on the current medical and reimbursement landscape. CareCloud helped bring total billing up by 56% and implement a customized MACRA Action Plan that met (and exceeded) CMS requirements.

Vanguard Rheumatology Customer Story
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