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Enterprise RCM partnershipMultistate 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
From partial support to a majority of RCM operations
- 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
AI-enabled tools across the claim lifecycle
RCM Analytics
DenialShield
FrontDeskShield (near-term rollout)
AI-enabled automation tools
Key results
Measured outcomes from the engagement
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
What changed for the business
Fully AI-enabled RCM program
Migration to a fully AI-enabled RCM program.
Centralized national operations
Centralized and standardized RCM operations and KPI reporting nationally.
Empowered in-house leadership
Empowered in-house RCM leadership supported by a scalable, cost efficient RCM team augmented by transparent, proactive and results-oriented technology solutions.
Denial reduction figures are based on initial DenialShield pilot results. FrontDeskShield rollout is anticipated near term.
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