Revenue Cycle Automation for a Multi-State Hospital Network
Client: US-based Hospital Network · Industry: Healthcare & Life Sciences
Outcomes
Technologies
Manual medical coding and claims submission across 12 facilities caused 34% denial rates, 90-day AR cycles, and $2M+ annual revenue leakage.
Built an AI-assisted medical coding engine (ICD-10/CPT) integrated with Epic EHR via HL7 FHIR APIs. Automated eligibility verification, prior-auth workflows, and real-time denial prediction using an XGBoost model trained on 3 years of claims data.