Case Study: Revolutionizing Healthcare Revenue Recovery with AI-Powered Denial Management

In today’s rapidly evolving healthcare landscape, providers face formidable challenges in navigating the intricate terrain of claim denials and appeals. Annually, these challenges accumulate to nearly $20 billion in potential revenue losses, exacerbated by manual processes and outdated systems that hinder efficiency. However, with the advent of Transworld System Inc (TSI)’s groundbreaking AI-powered Denial Management Solution, healthcare providers now have a transformative solution at their disposal.

Case Study: Boosting Donations For The Division Of Neonatology At A Midwest Health System

In the face of today’s intensely competitive landscape, health systems need to harness every tool at their disposal to achieve their goals and deliver exceptional patient care. One avenue that is often overlooked is the power of leveraging multiple channels, especially contact centers. These centers go beyond just addressing routine queries; they can be pivotal in supporting various strategic initiatives, optimizing patient interactions, and enhancing overall efficiency..

Midwestern Nonprofit Health Network

Staffing Challenges Led To An Increase In Accounts Receivable – TSI Healthcare Implemented A High-Balance Aged Insurance Follow-Up Program To Help Get Revenue Back On Track.​

Population Health Case Study

How TSI Healthcare Partnered With Umass Memorial Health To Enhance Overall Community Health​

Workers’ Compensation Program Case Study

This non-profit, 500-bed community hospital is located in the eastern United States. Although it had made great efforts to manage Workers’ Compensation and motor vehicle accident accounts, the corporate director of revenue cycle ultimately decided to seek outside help. Not only would this help quickly bring in revenue from these difficult accounts, but it would also free patient account representatives to focus on generating revenue from managed care and government-involved payers.

Workers’ Compensation Program Case Study

A not-for-profit health system serving communities in the Pacific Northwest was noticing a large increase of denied/unpaid Workers’ Compensation Claims, coupled with an overburdened staff unable to manage, follow-up, and adjudicate said claims. Executives decided to solicit Convergent’s expertise in order to determine next steps. During initial discussions, Convergent identified two issues resulting in the lower than average cash collections they were experiencing:

Veteran’s Administration Program Case Study

A large, non-profit Tennessee health system made the decision to begin focusing on payers outside of the Veterans Administration (VA), due to low recoveries, complexity and time-consuming nature of said claims. Determined to maximize reimbursement and meet their internal collection goal, they extended their existing partnership with Convergent Revenue Cycle Management (Convergent) to fully manage their VA Claims.

Patient Connect Case Study

A large healthcare provider and medical group in the Midwest was seeking an innovative approach to improve their level of patient engagement and population health quality initiatives.

Motor Vehicle Accident Case Study

A 500-bed Eastern Non-Profit reached out to Convergent RCM for assistance with a growing backlog of Motor Vehicle Accident accounts. Hospital executives were looking to, more quickly, generate revenue from these difficult claims and free staff to focus on current claims.

Aged INS Case Study

A large non-profit health care system’s Florida business office made the decision to focus on newer insurance claim denials and slow pays, thus necessitating assistance for the swiftly increasing backlog of aged receivables.