Case Studies

OutsourceRCM Boosts Client Revenue by 40%, Reduces Claims Denial by 80% in 6 Months


  • Our client is a leading medical billing company in California seeking assistance in managing large volumes of healthcare benefit claim forms.
  • We provided a comprehensive solution that included dedicated teams for efficient claim processing.
  • Our solution also incorporated a phased plan to eradicate backlogs and an automated system for streamlined claim capture and adjudication.

The Story of our Customer

  • Established in 2009 and based in California, our client is a distinguished player in the medical billing domain.
  • The company offers solutions for complex healthcare billing procedures, including claims processing and payment tracking.
  • The client had issues handling numerous complicated healthcare claims, leading to a backlog. They sought our help to manage this and establish a standard solution.

The challenge faced by our Customer

Confronted with a daily influx of thousands of healthcare benefit claim forms and related documents, the client struggled with the intricate nature of forms, variety in document types, and time-consuming processes.

  • The client struggled with a high volume of complex healthcare claim forms, leading to work overflow.
  • Diversity in document types and tedious tasks resulted in a growing backlog of claims.
  • The client needed a scalable solution to manage current and future claims, preserving customer relationships.

The Solution

In response to the challenge, a strategic solution was devised to optimize claim processing and overcome the backlog issue. The approach was multi-faceted, involving expert teams and innovative technologies to enhance efficiency and accuracy. The solution encompassed:

  • Specialized professionals were hired for efficient claim processing and backlog management.
  • An automated system was integrated for swift claim capture and error reduction.
  • A document management system was created, enhancing electronic claim submission and revenue increase.

The Result

The client greatly benefited from our tailored solution, realizing enhanced operational efficiency and improved financial performance. The key advantages encompass:

  • Reduced Denial Rate: Claim denials dropped by 30% within three months and further by 80% in the following three months.
  • Backlog Clearance: Drastic reduction and eventual elimination of pending claims backlog.
  • Timely Collection: Efficient and timely collection of all claims.
  • Substantial Savings: Achieved a remarkable 40% increase in revenues within six months.

Through our solution, the client achieved substantial improvements across their revenue cycle, establishing a more streamlined and profitable financial operation.

Elevate Customer Service with OutsourceRCM

OutsourceRCM is a top-tier BPO company offering global expertise from 5 delivery centers. Our inclusive services range from inbound support to outbound call solutions, delivering comprehensive resources for enhanced scalability.

For a reliable, profitable healthcare BPO partner, contact us today.