Client Profile
- Type: Community Hospital
- Specialty: General Medicine & Surgery
- Annual Patient Volume: ~85,000
About The Client
This hospital was facing mounting financial pressure due to rising denial rates, staffing shortages, and lack of visibility into revenue cycle performance. The CFO described the situation as “a constant firefight with no predictability in cash flow.”
Challenges
- AR cycles averaging 52 days
- Frequent payer denials draining revenue
- Manual coding checks causing variability
- No real-time insights into AR and denial trends
ImpactRCM’s Approach
To address these challenges, the hospital partnered with ImpactRCM, a trusted provider of AI-powered revenue cycle management solutions. The goal was to modernize operations, reduce administrative burden, and improve financial predictability.
What Was Implemented:
AI Denial Prevention Engine
Leveraged historical payer data to flag high-risk claims before submission, reducing preventable denials.
Automated AR Management
Intelligent agents followed up with payers, prioritized high-value claims, and streamlined workflows.
AI-Assisted Medical Coding
Combined compliance checks with human-in-the-loop validation to ensure accuracy across general medicine and surgical procedures.
Real-Time Analytics Dashboards
Delivered enterprise-wide visibility into AR performance, denial patterns, and reimbursement timelines, empowering leadership with actionable insights.
Results After 6 Months
| Performance Indicator | Before Implementation | After ImpactRCM Deployment |
|---|---|---|
| Accounts Receivable Days | 52 days | 38 days |
| Denial-Related Revenue Loss | High | Reduced by hundreds of thousands annually |
| Cash Flow Predictability | Unstable | Stabilized with faster reimbursements |
| Staff Efficiency | Low | Improved due to reduced manual workload |
| Financial Visibility | Limited | Real-time insights for leadership |
Potential outcomes
- Forecasting accuracy improved
- Staff could focus on complex cases
- Liquidity and financial planning strengthened
The CFO concluded:
“ImpactRCM didn’t just optimize our revenue cycle, it gave us back control. For the first time, we can forecast cash flow with confidence and focus more on patient care.”
Conclusion
This case study demonstrates how ImpactRCM’s intelligent RCM platform can help hospitals navigate the complexities of U.S. healthcare reimbursement. By integrating AI-driven denial management, automated AR workflows, and real-time operational intelligence, even mid-sized hospitals can achieve enterprise-grade efficiency.
