Case Studies

OutsourceRCM Boost Efficiency, Cut Costs by $60k & Slash Denials from 8% to 2%


Established in 2009, our client is a leading Minnesota-based Medical Billing and Consulting Leader, offering a comprehensive range of specialized services for over 100+ diverse medical accounts. Their expertise spans revenue cycle management, precise claims processing, insurance verification, benefits validation, coding optimization, and unwavering compliance.

In line with their ongoing dedication to process enhancement, the client aimed to establish a seamless eligibility verification process, ensuring accurate claims processing and timely payments without delays.

Story of the client

  • Founded in 2009, our client is a prominent Minnesota-based Medical Billing and Consulting firm, providing advanced services to over 100 medical accounts.
  • With 15 years of experience, they've built trustworthy relationships and boosted client profitability through innovative technology and superior back-end support.
  • They offer comprehensive services like revenue cycle management, claims processing, insurance verification, benefits validation, coding optimization, and industry regulation compliance.

The Challenge

  • Implementing an efficient and streamlined eligibility verification process to enhance operational efficiency.
  • Ensuring precision in claims processing to minimize errors and improve overall billing accuracy.
  • Mitigating the risk of payment delays to clients by optimizing the claims submission and validation procedures.

The Solution

We executed a comprehensive approach to optimize the client's insurance eligibility and benefits verification process, which can be summarized as follows:

  • Dedicated verification team, trained and integrated with client's staff.
  • Streamlined verification documents.
  • Pre-appointment protocol with 48-hour lead time.
  • Real-time walk-in patient verification, 1 hour before appointments.
  • Swift insurance authorization and referrals.
  • Timely insurance issue resolution for efficiency and satisfaction.

The Result

  • Empowered pre-registration staff with streamlined insurance verification, reducing costs and expanding roles.
  • Achieved 50% coverage query fee reduction, saving $60,000 annually.
  • Significantly lowered coverage denials from 8% to 2%, in line with best practices.
  • Enabled industry-leading admissions and financial clearance practices.
  • Cut eligibility FTEs by 80%, reducing staff from 5 to 1 with OutsourceRCM' seamless services.

Leverage OutsourceRCM to Serve the Customers Better

OutsourceRCM is a leading business process outsourcing firm with five global centers. We offer a range of services including inbound support and outbound call center solutions. Our approach combines human expertise, technology, infrastructure support and quality assurance to enhance your business operations.

If you seek a dependable, lucrative and synergistic healthcare BPO partner to reach your goals, you can contact us promptly.