Customer Success Story
AI-Powered Denial Management Increases Reimbursements & Cuts Resolution Time by 50%
- Organization: Large Multi-State Health System
- Annual Revenue: $5.2 Billion
- Challenge: High denial rates, slow appeals, and revenue leakage due to manual processes
- Objective: Reduce denials, accelerate appeal resolutions, and improve reimbursement success
The Challenge
A leading multi-state health system was facing escalating denial rates (14% of total claims), prolonged appeal resolution times (average of 65 days), and significant administrative burdens on their revenue cycle team. With millions in delayed reimbursements and excessive manual efforts, they sought a technology-driven solution to:
- Reduce preventable denials
- Automate the appeal process
- Improve claim recovery speed and success rates
- Minimize administrative workload and rework
The Solution
TSI’s AI-Powered Denial Management
TSI deployed its AI-driven denial management platform, integrating seamlessly with the client’s EHR and RCM systems. The solution included:
✔ AI-Powered Denial Prevention – Predictive analytics identified and corrected errors pre-submission, preventing 30% of denials before they occurred.
✔ Automated Appeals Submission – AI-generated, data-backed appeal letters were instantly customized for each payer’s policies, increasing overturn rates by 40%.
✔ Real-Time Payer Intelligence – Machine learning analyzed payer behavior and updated appeal strategies in real time, reducing rework by 35%.
✔ Workflow Prioritization & Smart Routing – AI ranked and routed denials based on recovery probability, cutting resolution time by 50% and accelerating cash flow.
✔ Seamless Integration – The solution worked within the client’s existing system, requiring zero additional IT lift and providing real-time insights via an intuitive dashboard.
Results & Impact
📈 Denials Prevented: 30% reduction in preventable denials
📈 Appeal Success Rate: 40% increase in overturned denials
📉 Resolution Time: 50% reduction in denial appeal turnaround time (from 45 to 22 days)
📉 Admin Burden: 35% decrease in manual rework & touchpoints
💰 Revenue Impact: $28M in accelerated reimbursements within the first 12 months
"TSI’s AI-powered denial management completely transformed our revenue cycle. The automation eliminated bottlenecks, improved our cash flow, and freed up our team from repetitive tasks. We saw a 40% increase in successful appeals and a dramatic reduction in denial resolution time—this solution paid for itself within months.”
- VP of Revenue Cycle, Multi-State Health System
Conclusion
Smarter Denial Management, Stronger Bottom Line
With TSI’s AI-driven denial management, this leading health system reduced denials, streamlined appeals, and maximized revenue—all while cutting administrative workload.
🔹 Ready to recover more, faster? Contact TSI today to see how AI-powered denial management can optimize your revenue cycle.
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