A regional medical group operating 45 locations across three states had never done a structured telecom expense review. Telecom was managed reactively — invoices were approved when they came in, contracts renewed when vendors contacted the finance team, and no one had a clear picture of what services were active at which locations.
The organization’s growth through acquisitions over the prior decade had added to the complexity. Each acquisition brought carrier relationships, billing accounts, and service agreements that were integrated into operations but never audited. The finance team’s internal estimate was that telecom costs were “probably in the right range,” but no one had verified that assumption.
The catalyst for engagement was a CFO-level initiative to identify cost reduction opportunities across operating expenses ahead of a system expansion. Telecom was identified as a category where meaningful savings were likely but where the team lacked the methodology to quantify them.
Unravyl began with a full data collection phase: 12 months of invoices across all carriers, all service contracts and agreement documents, a location list with operational status for each site, and the billing account structure across the organization.
The invoice review covered wireline voice services (PRI circuits, SIP trunks, POTS lines), internet circuits (fiber, broadband, and a remaining T1 portfolio from an earlier acquisition), network services, and conferencing. The contract review covered each carrier relationship — AT&T, Lumen, a regional CLEC, and a VoIP provider.
Once data was organized, Unravyl built a service-to-location map: every circuit and service matched to the location it was supposed to serve, along with the operational status of that location. This mapping — which the organization had never done internally — produced the first complete picture of what the telecom environment actually looked like.
Healthcare
Mid-market ($100M–$1B)
45
Telecom Expense Management, Contract Negotiation
10 weeks
Six-figure annual recurring savings, plus one-time credit recovery
The service-to-location mapping produced findings that went well beyond what the finance team expected:
Seven locations that had been closed, consolidated, or converted to a different operational model over the prior four years were still being billed for voice circuits, internet circuits, or both. The carrier billing systems had not been updated when locations closed. Monthly cost for these circuits: $14,200. Annual: $170,400.
Three carrier accounts had billing discrepancies — services billed at list rate that the contracts specified at discounted rates, a feature package being charged that the contract had excluded, and a circuit being billed at a higher bandwidth tier than what was provisioned. Combined billing error value: approximately $3,800 per month.
The two largest carrier contracts — covering the majority of the circuit and internet spend — had not been renegotiated since signing. One contract was six years old; the other was four years old. Both had auto-renewed at original pricing multiple times. Market pricing benchmarking showed both were significantly above current rates.
A legacy conferencing account from an acquired organization was still active and billing. The organization had migrated to a different conferencing platform three years earlier. Monthly cost: $980.
Eleven POTS lines across four locations could not be attributed to any active function. Likely installed for fax machines, elevator phones, or security systems that were either still functional or had been removed. Each required a site-level verification to determine disposition.
Unravyl presented findings and a prioritized action plan organized into three tracks:
The closed-location circuits, unused conferencing account, and confirmed-unnecessary POTS lines were submitted for disconnection. Carrier disconnect orders were drafted and submitted with appropriate notice language to avoid early termination charges.
Formal billing disputes were filed with each carrier for the identified billing errors. Credit recovery totaled approximately $34,000 for billed amounts dating back 12 months.
Unravyl prepared a benchmarking analysis for both major carrier contracts using current market rate data. Negotiation was conducted directly with carrier account teams, using the disconnect pipeline as leverage and multi-year commitment as the primary negotiation asset. Both contracts were renegotiated.
Site-level verification of the 11 unattributed POTS lines was conducted over four weeks with facilities and IT contacts at each location. Six were confirmed unnecessary and disconnected. Five were confirmed active for elevator, security, or legacy fax purposes and documented for ongoing tracking.
Total annual recurring savings from the engagement:
One-time credit recovery from billing disputes: approximately $34,000.
Beyond the savings figures, the organization ended the engagement with a complete telecom inventory, a carrier contract file with renewal dates and notice windows, and an internal process for location-change notifications to carriers — addressing the root cause of the closed-location billing problem.
Healthcare organizations that have grown through acquisition — or that have expanded location footprints over time — consistently carry higher telecom waste than organizations with stable, single-site footprints. The combination of legacy carrier relationships from acquired entities, location changes that don’t get communicated to carriers, and passive contract management creates the conditions for this type of finding.
The telecom billing systems of major carriers are not designed to catch these issues — they bill what the account says to bill until someone tells them otherwise. The only way to surface closed-location circuits, billing errors, and overpriced contracts is a structured, invoice-level review. Most healthcare finance teams don’t have the bandwidth or vendor-specific knowledge to do this work internally.
Start with a focused review of your telecom spend, contracts, and service inventory. Most clients are surprised by what a structured audit uncovers.
