How It’s More Than Speech got their billing (and evenings) back

From 8,000 backlogged claims to breathing room 

Nobody opens a speech therapy practice because they love insurance claims. Andrea Toth certainly didn’t. She opened It’s More Than Speech for the moments therapy is actually about: a toddler finding their first words, a child on the spectrum finally being understood. As the practice’s owner and founder, she still spends most of her week right there in the therapy room, seeing around 30 clients while running a growing practice across two Alaska communities. 

But like so many practice owners, Andrea found herself watching the business side threaten the mission side. Behind the scenes, a billing relationship the practice had outgrown was quietly burying the team, more than 8,000 unworked claims deep. 

For a rehab therapy practice, that kind of backlog is not just a financial problem. It creates uncertainty for the team, adds pressure to already busy clinicians, and pulls attention away from spending time with clients.

8,000 claims and a question of trust 

Bryce Clifford sees the business side up close. As clinical operations manager, he handles credentialing, intake, claim denial management, and reporting, everything that keeps the practice able to, in his words, “continue to serve the kids in the community.” And as the practice grew, he watched its previous billing company fall further and further behind. 

Claims piled up unworked, eventually topping 8,000. Information lived across multiple systems, and getting a straight answer about why things were happening became a struggle. The company had served the practice well when it was smaller, but it could no longer keep up with the volume. 

Then came the moment that changed everything: the practice received inaccurate information about insurance guidelines from the very people hired to know them. 

“The trust was a little bit gone for me. That was the defining moment that we needed to start working towards finding a company that would partner with us and was transparent.” 

– Bryce Clifford, Clinical Operations Manager, It’s More Than Speech 

The team faced a familiar crossroads. Hire more admin staff? Bring billing in-house? Or find a partner who could actually carry the load? 

Finding a way forward with Ensora Health

The answer came in three decisions. The first was the EHR. Bryce had used Fusion by Ensora Health, an EHR built for therapy practices, at a previous clinic and remembered how user-friendly it was. When he and the admin team went searching for a system that could cut down on ballooning admin time, Fusion stood out, and the practice made the switch. 

“They understand the operational realities behind therapy services, and they’re able to bridge the gap between clinical operations and reimbursement.” 

– Bryce Clifford 

The second decision was billing. Alongside Fusion, the practice added Ensora RCM, a revenue cycle management service that puts Ensora’s expert billing team to work on claims processing, denials, and follow-up. Andrea didn’t sign on lightly. Turnover at her previous billing company had burned her before, so before committing, she asked Ensora one question: what happens when your people leave? To answer it, Ensora put her in touch with two of its own customers, practice owners who told her they had worked with the same Ensora team members for years and never had to worry about a lapse in support. Andrea has since seen that stability for herself: when a role on her account changed, there was an introduction, a gradual transition, and the outgoing person stayed involved until the handoff was complete. 

The third decision was documentation. Andrea added Ensai Session Assistant℠, Ensora’s AI-enabled documentation tool inside Fusion that captures the session and drafts the clinical note. She trialed it herself for two weeks, then trained her staff and rolled it out to the whole team. 

Three decisions, one partner. And in Ensora, the practice found the responsiveness that had been missing. 

“They are supportive, responsive to our questions, very knowledgeable. If they don’t have an answer, they find one.” 

– Andrea Toth, Owner and Founder, It’s More Than Speech 

What followed were two transformations. The first played out in the back office, where the claims backlog was waiting. The second happened in the therapy room itself. 

Working down the mountain 

The Ensora RCM team started with the backlog: more than 8,000 unworked claims, many untouched for months. Instead of reacting to problems as they surfaced, the team began systematically identifying, organizing, and addressing outstanding claims, and built accountability around claim follow-up, denial management, and reporting. The time Bryce’s internal staff spent researching billing issues dropped significantly. 

Then came a discovery that changed the practice’s cash flow. For years, the team had been told that Alaska Medicaid secondary claims could only be submitted on paper, mailed in, and paid whenever the mail caught up. Ensora disproved it almost immediately: those claims could go electronic, and now every one of them does. After years of envelopes and waiting, money the practice had already earned started arriving weeks sooner, and the manual work of chasing paper claims disappeared with it. 

“We can submit secondaries electronically, and this has been a huge benefit to us. Before, they were being mailed, and it takes a long time. That cut down the turnaround time by weeks.” 

– Bryce Clifford 

Notes done before dinner 

While the RCM team rebuilt the billing side, Ensai Session Assistant℠ was quietly transforming the clinical side. Before, Andrea routinely ended the week with 10 to 15 notes still to write, catching up on Saturdays and Sundays just to start Monday clean. Now she ends most days with one or two notes left, and her therapists, who once stayed late or worked weekends to finish documentation, are leaving at their scheduled time. 

“With the AI assistant, I end most of my days with maybe one or two notes left. It’s a huge game changer on therapist burnout.” 

– Andrea Toth, Owner and Founder, It’s More Than Speech 

The notes themselves got better, too. Because the session is captured as it happens, Andrea’s documentation is more descriptive than anything she could reconstruct from memory a day later, and she can stay fully present with the child in front of her. 

“I’ve told parents, it’s actually most important that it’s recording me so that I can just think about your child.” 

– Andrea Toth 

The results are clear 

A broader overview of the results: 

• Backlog under control: 8,000+ unworked claims moved from ignored to systematically identified, organized, and addressed. 

• Paper eliminated: Medicaid secondary claims that once traveled by mail now go through electronically and pay in a fraction of the time. 

• Better cashflow: Weeks faster payment turnaround since moving those claims off paper. 

• A team that leaves on time: Therapists who once stayed late or worked weekends to finish notes now walk out at their scheduled time. 

• Admin relief: Accountability around claim follow-up, denial management, and reporting has significantly cut the time staff spend researching billing issues. 

More than software, a partner

Beyond the headline results, the everyday tools inside Fusion keep earning their place: HIPAA-compliant messaging that replaced carefully worded texts and scattered emails, reporting Bryce can rely on to see accurate numbers in one place, reminders that keep busy admin schedules on task, and plan of care tracking that flags upcoming reassessments and keeps the practice compliant. 

Asked to describe the Fusion team in three words, Bryce chose “collaborative, consistent, and thorough.” Andrea’s three: “knowledgeable, responsive, and reliable.” 

“I would recommend Ensora because they understand the operational realities behind therapy services, and they’re able to bridge the gap between clinical operations and reimbursement.” 

– Bryce Clifford 

Join the practices finding a better way 

With billing stabilizing and evenings freed up, Andrea is back to building. The practice is growing its occupational therapy program, taking on interns, and working toward her long-held vision: multiple disciplines under one roof, so Alaska families can get more of their care in one place. 

It’s More Than Speech is proof that a practice doesn’t have to choose between growing and staying sane. With the right partner, the business side runs while the team focuses on the kids. 

If your practice is ready to reshape its story, Ensora Health is here to help. 

Schedule a demo of Fusion + RCM today and see how we can help you put your mission back in focus.