Ryan Russell

Owner and Clinical Director

Shaeleigh Russell
Office Manager & RCM Liaison

That kind of growth is the goal, but it also creates pressure that can quietly compound in the back office.

One Person, Too Many Hats

With a growing patient volume across three locations, Empowered Prosthetics & Orthotics’ internal billing capacity wasn’t keeping pace. Araceli was handling claims while also managing other administrative duties, a setup that worked when the practice was smaller but wasn’t sustainable at scale. The question wasn’t whether the team was capable. It was whether the structure could support what Empowered Prosthetics & Orthotics was becoming.

“We needed to offload billing, improve efficiency, and support our growth. One person doing it all while managing other admin responsibilities wasn’t going to cut it as we scaled.”

The Fear Every Practice Owner Understands

For many P&O business owners, the hesitation around supplemental RCM support is rooted in control. Billing isn’t just administrative. It’s tied to how a practice communicates with payers, represents its patients, and protects its cash flow. Handing any part of that off feels like a risk.

Ryan felt that tension directly. But working with Nymbl’s RCM team reshaped how he thought about what supplemental support actually means.

“Giving up control of it is hard for us. I think that would be a hesitation for a lot of business owners. But this isn’t outsourcing and forgetting. You’re utilizing a team that becomes part of your team. You’re integrated and interdependent, and that’s where it’s most successful.”

Rather than replacing their internal team, they structured the arrangement so that Shaeleigh served as the primary liaison between Empowered Prosthetics & Orthotics and Nymbl’s RCM specialists.

“I came in with little prior billing experience. What I didn’t expect was how much I’d learn. Nymbl’s team is incredibly responsive. They don’t just handle the work, they explain it. I’ve become a much more effective part of this process because of them.”

How the Partnership Works Day to Day

Empowered Prosthetics & Orthotics’ model is intentionally collaborative. Nymbl’s RCM team handles the billing volume and complexity while Shaeleigh owns communication, documentation support, and workflow coordination on the practice side. Responsibilities are clear, and neither team operates in isolation.

“It’s supplemental and collaborative, not a full takeover. I’m the point person, and that structure makes everything run more smoothly. When a question comes in or something needs to be escalated, it goes through me and we resolve it together.”

Higher Standards, Fewer Denials

One unexpected dynamic: Nymbl’s RCM team brought a higher bar for documentation compliance than Empowered Prosthetics & Orthotics’ internal process had previously required. That initially created some friction as providers had to adjust to more thorough documentation expectations, but the payoff was meaningful.

“Nymbl’s standards for documentation are high. That created some extra work on our end at first. We had to educate providers and change some habits. But it’s made us more compliant, and we’re seeing fewer denials as a result. The short-term friction was worth it.”

The Outcome

Since partnering with Nymbl RCM, Empowered Prosthetics & Orthotics has seen faster reimbursements, a reduced administrative burden on their internal team, and cleaner claim submissions driven by stronger documentation standards. With billing operations supported, Araceli can dedicate more time to higher-impact priorities across the business.

Beyond the operational metrics, Shaeleigh describes a shift in her own confidence and competency. Rather than being handed off work she didn’t understand, she’s been educated through the process, developing billing knowledge that makes her a more effective liaison and a stronger contributor to the practice overall.

What Empowered P&O Would Tell Other Practices

For P&O practice owners weighing supplemental RCM support, Ryan’s advice is grounded and direct: the fear of outsourcing is legitimate, but it’s manageable, and the upside is real. The key is treating it like a true partnership, not a service you buy and walk away from.

“It’s not ‘set it and forget it.’ The practices that get the most out of this are the ones that stay actively involved. Designate a point person, communicate clearly, and expect some disruption upfront. That’s the price of a transition that’s genuinely going to improve your financial health.”

“If you’re nervous about it, start by thinking about what your team is actually spending time on. If billing is pulling people away from where they’re most needed, that’s your answer. Nymbl doesn’t take over. They free you up.”

Scalable RCM Support

Extended internal billing capacity without displacing staff or workflow ownership

Reduced Denial Rates

Nymbl’s high documentation standards improved claim quality and decreased denials

Designated Point Person Model

Shaeleigh Russell serves as the practice-side liaison, keeping communication streamlined and accountability clear

Team Development

Internal staff gained billing knowledge and competency through active collaboration with Nymbl’s RCM team

Faster Reimbursement

Improved payment speed and reduced timeto-collection since engagement began

Reduced Admin Burden

Internal biller freed from billing overload to focus on higher-value responsibilities