From guesswork to time back with patients
How Central Coast Lymphedema built Sandy into the daily workflow: documenting 140+ visits a week, recovering about two working weeks of clinician time a month, and giving patients a clear cost before they walk in the door.
The practice
Central Coast Lymphedema is an independent specialty practice serving patients with complex lymphedema and oncology rehabilitation needs. The patients are medically complicated, the work is highly hands-on, and the documentation has to be detailed enough to support careful clinical decisions, accurate billing, and continuity of care visit after visit.
CCL is run by two clinicians. Jamie Cinotto is the practice's physical therapist. Hashim Jaderanii, PTA, CWW, CLT, is the wound care provider. Between them they carry the full clinical load, 140 or more captured encounters in a typical week. Two questions hang over every appointment: what will this visit cost the patient, and what will the practice actually be paid? Until recently, both answers arrived late, if at all.
The challenge: a chaotic system, one patient at a time
The math has worked against small specialty practices for years. Reimbursement has been roughly flat while documentation and billing requirements have climbed, and the back-office staff needed to absorb that burden often costs more than a practice can add. So the work lands on the clinicians. At CCL, the front office spent all-in a full working day every week calling payers, hunting for benefit details, hand-keying eligibility, and bracing for the next denied claim or surprise bill.
The clinical side felt the same pressure from the other direction. Every minute spent typing notes or reconstructing a session at the end of the day was a minute not spent with the next patient, and a backlog of orders, wound updates, referrals, and billing-ready notes piled up behind care.
The solution: one continuous workflow
CCL did not adopt two products. They adopted a connected workflow that runs the length of every appointment, so the financial and clinical sides of the practice finally speak the same language, on the same day, about the same patient.
Verification of Benefits returns coverage, deductible, copay, and an estimated patient cost, ready to share before the patient arrives.
AI Scribe captures the encounter and structures the note. Medical coding extracts the right CPT and HCPCS codes from the documentation.
Post-visit re-estimation reconciles the actual services performed, explains any cost change to the patient, and hands a clean claim downstream.
AI Scribe at the center of the day
Scribe is what CCL adopted first, and it shows. Within two weeks of full rollout the practice was running 140-plus Scribe sessions a week and held steady, staying in a tight 132-to-156 range across seven consecutive weeks. That is not trial usage, it is a workflow. On a typical day, the two clinicians run about 29 sessions and finalize their notes between patients, capturing roughly 19 minutes of clinical conversation per visit and turning it into a structured note ready for review.
March 30 to May 5, 2026 · five weeks of steady-state Scribe usage
Verification of Benefits
With Scribe stable at the center of the day, CCL is now layering Verification of Benefits in front of every visit. Sandy runs eligibility automatically, returns active coverage, deductible, copay, and coinsurance, and produces an estimated patient responsibility built from CCL's payer contracts. Network status is classified from payer responses and contract data, so there is no call to the payer in the first place. The estimate is transparent, confidence-scored, and ready to share before the patient arrives.
The transformation
Each workflow is useful on its own. Together they compound: Scribe gave the clinicians their evenings back and turned documentation into something that happens during care, not after it, and Verification of Benefits is turning the front office's busiest manual job into an automated step.
What's next
CCL is scaling Verification of Benefits across the full schedule. Post-visit re-estimation will then reconcile the services actually performed against the pre-visit estimate on every appointment, and 90-day forecasts will show, month over month, how accurately the practice was paid.