Note: To protect clinical operations and patient privacy, the practice featured in this case study has requested to remain anonymous.
Overview:
A growing vein health group operating across three locations in New York faced a challenge common to specialty practices managing high patient volumes: no-shows and cancellations were creating significant revenue gaps, online patient demand was not being fully captured, and a lean administrative team was struggling to keep pace with the complexity of coordinating a multi-provider, multi-location schedule. After implementing Holly AI, the practice generated $275K+ in measurable annual value. A key driver was the systematic recovery of lost revenue: $61K+ recaptured from no-shows and cancellations through automated rescheduling. Beyond that, the practice secured $199K+ in new patient revenue from online bookings and automated inbound calls, and saved $15.4K in staff hours through automated front-desk workflows, delivering a 20X return on investment.
14 Providers
3 Locations
12,133 Yearly Appointments
About the Practice:
This vein health practice was built around a straightforward mission: make expert vascular care accessible, precise, and genuinely patient-centered. Operating across three locations in New York with a team of 14 providers, the practice offers comprehensive diagnosis and treatment for a wide range of venous conditions, including varicose veins, spider veins, chronic venous insufficiency, and deep vein thrombosis. Treatments are designed to be performed in-office with minimal downtime, and care plans are tailored to each patient's clinical presentation and lifestyle. The practice's commitment to clinical precision and accessibility has made it a trusted provider for patients across its New York locations, many of whom are managing chronic conditions that require ongoing monitoring and follow-up.
Industry Overview:
Chronic venous disease is one of the most widespread yet significantly underdiagnosed conditions in the United States. According to the Society for Vascular Surgery, chronic venous insufficiency may affect up to 40% of the U.S. population, and research published in the Journal of Vascular Surgery estimates that more than 25 million Americans are already living with the condition, with total care costs exceeding $3 billion per year. According to NIH data, approximately 150,000 new patients are diagnosed with chronic venous insufficiency each year, and if left untreated the condition typically progresses toward more serious complications, including venous ulcers and chronic pain that significantly diminish quality of life.
The clinical burden is expected to grow. An aging population, rising rates of obesity, and increasingly sedentary lifestyles are all well-established risk factors, meaning demand for vein health services will increase steadily in the years ahead. For specialty practices, this represents a growing responsibility to expand access and maintain the continuity of care that chronic venous disease patients require over time.
Doing that well demands more than clinical capacity. It requires operational infrastructure capable of managing a larger, more complex patient population consistently across providers and locations. Yet practices are already under pressure. According to MGMA, single-specialty no-show rates rose to 6.81% in 2023, and in procedure-based settings like vein clinics, every missed appointment represents a missed procedure, not just a missed consultation, directly affecting both patient outcomes and practice revenue. At the same time, 92% of medical groups reported that operating expenses increased in 2024, with labor costs consistently accounting for the largest share. For multi-location specialty practices, these pressures compound with every new provider and site added, making operational efficiency not just a financial priority but a clinical one.
The Challenge:
The practice was navigating four interconnected challenges.
1. Revenue Lost to No-Shows and Cancellations
With over 12,000 appointments per year across three locations, even a modest no-show rate translated into significant and recurring revenue loss. Patients who missed or cancelled appointments were not being systematically re-engaged, and without a recovery process in place those slots went unfilled. In a procedure-based specialty where each visit represents a clinical intervention with meaningful financial weight, the cumulative impact was substantial and growing.
2. Converting Online Search Traffic into Booked Appointments
Patients searching for vein care in New York have no shortage of options. The practice had the clinical reputation and the locations, but lacked the infrastructure to capture patients at the moment of intent. Visitors landing on their website or finding them through a Google search had no immediate way to book, meaning a significant share of organic interest was not converting into appointments. Every day without a frictionless online booking path was potential patient demand left uncaptured.
3. Coordinating a Multi-Provider, Multi-Location Practice at the Right Level of Detail
Managing patient communication across 14 providers and three locations goes beyond volume. Vein health patients often require ongoing care across multiple visits, and different appointment types carry different pre-visit requirements. Sending the right pre-appointment instructions to the right patient for the right appointment type, consistently and at scale, was not something the team could manage manually without errors or gaps. The practice needed a system that could handle that level of clinical and operational detail automatically.
4. Capturing Patient Information at the Moment of Booking
Incomplete or delayed patient intake created downstream friction across scheduling, billing, and clinical preparation. When demographic and insurance information was not captured upfront at the moment of booking, whether online or by phone, staff had to chase it down later, adding administrative burden and slowing the patient journey before the first visit had even taken place.
The Solution:
In 2025, the practice began a free pilot of Holly by Nimblr, an AI Operator that automates patient communication and front-desk workflows by managing the platforms the practice already uses, including their EHR, payment systems, and more. The pilot launched at a single location, fully supported by the Nimblr team, with no new software to install and no staff training required. Once the results demonstrated clear operational and financial impact, the practice moved forward with a full deployment across all three locations.
What made the difference at scale was not just automation, but intelligent automation. Holly operates across 28 patient journey workflows and over 350 operational rules, creating thousands of configurations tailored to the practice's specialty, providers, and scheduling patterns. Across three locations and 14 providers, every patient interaction from first booking to post-procedure follow-up is handled consistently and according to the practice's own clinical and operational standards, without manual coordination.
Each of the four challenges the practice faced had a specific and measurable response.
* For no-show and cancellation recovery, Holly's automated rescheduling system initiated outreach via SMS the moment a patient missed an appointment or cancelled, offering available slots to patients on the waitlist and handling rescheduling without staff involvement. Revenue that had previously gone unrecovered became part of a consistent and systematic process, recapturing $61K+ in a single year.
* For online patient acquisition, Holly's native Google Business integration allowed patients to book directly from organic search results, while the web scheduler embedded in the practice's website converted site visitors into booked appointments around the clock. These two channels gave the practice a way to meet new patients at the moment they were actively looking for care.
* For pre-appointment coordination, Holly automatically delivered appointment-type-specific instructions to each patient based on their scheduled visit, across all three locations. This ensured clinical preparation was consistent and complete regardless of which provider or site the patient was scheduled with, reducing errors and last-minute gaps.
* For demographic and insurance capture, Holly collected patient information at the moment of booking, whether through the website or by phone. Intake was completed before the first visit, eliminating the downstream friction of chasing incomplete records and giving staff accurate information from the start.
Together, these four capabilities plus the automation of reminders, confirmations, and routine patient communication tasks offloaded 1,027 work hours from the team across a full year, reducing operational burden and increasing front-desk efficiency across the entire group.
Yearly Results:
$61K+ Recovered Revenue from No-Shows and Cancellations
$199K+ New Patient Revenue from Online Bookings and Automated Inbound Calls
$15.4K Savings in Staff Hours
20X Return on Investment
Going Forward:
The practice has established three new drivers of sustainable performance. Appointments that previously disappeared from the schedule are now systematically recovered through automated rescheduling, turning a recurring revenue gap into a reliable recovery process. New patient revenue streams have opened through online bookings, Google Business integration, and inbound call automation around the clock, channels that did not exist before. And with pre-appointment instructions, patient information capture, reminders, and confirmations now fully automated across all three locations, front-desk operations run more efficiently and the administrative burden of repetitive communication tasks has been substantially reduced.
Looking ahead, the practice sees Holly as a core part of its expansion strategy. As the group continues to grow, the priority is to increase adoption of inbound call automation across all locations and deepen the use of Holly's capabilities to support a larger and more diverse patient population, without adding operational complexity in the process.