Client Profile
- Type: Multi-Hospital Health System
- Network Size: 5 hospitals, 1,200+ beds
- Annual Patient Volume: Approximately 500,000
About The Client
This Midwest-based health system comprises five hospitals serving a mix of urban and rural populations. With over 1,200 inpatient beds and half a million patient visits annually, the organization delivers a wide range of general and specialty care services. The scale of operations, combined with a diverse payer mix, made revenue cycle management increasingly complex. Each hospital operated with its own workflows and systems, leading to fragmented processes and inconsistent financial performance.
Challenges
Despite its clinical excellence, the health system faced several operational and financial hurdles:
- Denial rates exceeded 12%, resulting in millions of dollars in lost revenue annually
- Fragmented RCM systems across hospitals created inefficiencies and reporting gaps
- Accounts Receivable (AR) days averaged 58, delaying reimbursements and straining liquidity
- Heavy reliance on contract staff increased administrative overhead and reduced scalability
The leadership team recognized the need for a unified, intelligent revenue cycle strategy that could scale across facilities and deliver measurable outcomes.
ImpactRCM’s Approach
To address these challenges, the health system partnered with ImpactRCM, a leading provider of AI-powered revenue cycle management solutions for healthcare organizations. The implementation focused on standardization, automation, and real-time visibility.
Key Components:
Centralized AI Denial Management
AI agents identified denial-prone claims across all facilities and reduced resubmission workloads by 40%
Unified AR Automation
Automated follow-ups and intelligent routing ensured high-priority claims were escalated instantly
Standardized Coding & Compliance
AI-assisted coding enforced uniformity and payer-specific compliance rules across hospitals
Leadership Dashboards
Delivered enterprise-wide visibility into AR, denials, and performance metrics for CFOs and hospital CEOs
Results After 9 Months
| Performance Indicator | Before ImpactRCM | After ImpactRCM |
|---|---|---|
| Denial Rate | 12% | 6% |
| AR Days | 58 | 41 |
| Contractor Dependency | High | $2.3M saved annually |
| Executive Visibility | Fragmented | Full system-wide insights |
Potential outcomes
- Millions recovered in preventable denials
- Operational consistency across all hospitals
- Reduced administrative overhead
- Strategic decision-making enabled by real-time analytics
Conclusion
This case study highlights how ImpactRCM’s enterprise-grade RCM platform enables large health systems to overcome fragmentation and financial inefficiencies. By integrating AI-driven denial prevention, automated AR workflows, and centralized analytics, ImpactRCM helped this Midwest health system unify its revenue cycle operations and regain financial control.
ImpactRCM empowers healthcare networks to:
- Accelerate reimbursements
- Reduce denial rates
- Improve coding compliance
- Eliminate contractor dependency
- Strengthen financial governance across facilities
