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Multistate MSO Enterprise RCM Partnership

A ~$100M multi-site MSO operating across four states with six separate EMR systems partnered with SCALE to modernize and centralize its Revenue Cycle Management (RCM).

Engagement Evolution

  • Initial deployment: Partial RCM support (eligibility, prior auth, coding, payment posting)
  • By Month 13: Expanded to majority of RCM operations, including:
    • Eligibility verification
    • Prior authorization
    • Charge entry
    • Coding
    • Payment posting
    • A/R & denials management

SCALE staffing scaled significantly from 6 → 52 FTEs over 13 months.

Technology Implemented

  • RCM Analytics
  • DenialShield
  • FrontDeskShield (near-term rollout)
  • AI-enabled automation tools

Key Results

  • 24% reduction in A/R days
  • 22% reduction in A/R outstanding
  • 50% reduction in billing lag time
  • ~50% reduction in denials (pilot results)
  • 50%+ reduction in cost-to-collect

Strategic Outcomes

  • Migration to a fully AI-enabled RCM program
  • Centralized and standardized RCM operations and KPI reporting nationally
  • Empowered in-house RCM leadership supported by scalable, cost efficient RCM team augmented by transparent, proactive and results-oriented technology solutions
"Tech-enabled RCM transformation for multistate MSO, enterprise revenue cycle partnership, AI tools, billing improvements, Scale Healthcare case study."