The Problem:
A Midwest-based outpatient health system with more than 100 clinics came to Vee Healthtek with a major problem: each month, preventable eligibility denials impacted approximately $8 million in claims. These denials disrupted the organization’s cash flow, overwhelmed its staff, and caused detrimental downstream revenue leakage.
Knowing it urgently needed a solution to overhaul its denial workflows and streamline intensive, manual processes, the health system turned to Vee Healthtek, a leading provider of AI-driven solutions that drive financial impact, to help. With over twenty-five years of trusted revenue cycle expertise and experience serving 7 of the nation’s top ten healthcare organizations, Vee Healthtek was the health system’s first choice to improve revenue recovery, increase quality, and enhance operational efficiency.
Our Solution:
Vee Healthtek’s denials experts stepped in, performing a full-spectrum root cause analysis and providing detailed analytics for smarter decision-making. Missing documentation, incorrect insurance and demographics data, and slow, manual workflows were identified as the top reasons for the 240 denials, which directly contributed to sizeable revenue loss. With these causes pinpointed, we partnered closely with the health system to implement RevAmp, our revenue cycle management automation platform that fuels operational excellence and robust financial performance with artificial intelligence (AI), agentic AI, natural language processing (NLP), and predictive data modeling to increase efficiency, accuracy, and productivity.
As part of our technology-enabled solution, we deployed RevAmp’s proprietary agentic AI, Emily, to verify eligibility status over the phone and through EDI transactions according to custom prioritization workflows. With the capability to launch hundreds of direct payer communications simultaneously, Emily cleared bottlenecks and inefficiencies that delayed authorization and, ultimately, reimbursement. Focusing on high-risk verifications first, Emily accelerated processes that had historically stalled care and payment.
Using our revenue cycle dashboards and reporting tools, our AI verification solution continuously analyzed historical eligibility denials data to optimize for faster throughput and superior resource allocation. This ongoing maturation of our AI technology resulted in further increases in accuracy and productivity by intelligently adjusting workflows based on payer behavior and prior outcomes.
Our Value:
In just five months, Vee Healthtek’s agentic AI and automation platform achieved remarkable results for the health system, completely transforming its financial outlook and bottom line.
By automating eligibility and benefits checks across thousands of patient encounters and performing payer direct connect with RevAmp, we increased verification timelines by 133%, which yielded a 41% boost in productivity and a 39% reduction in labor hours. This freed up staff to focus on higher-value work while also substantially lowering its operational costs.
As a result of our technology-enabled workflow processes, we reduced eligibility denials by 26%, saving our client more than $3.6 million each month on average. The health system was incredibly impressed that our solution accelerated reimbursement and enabled significant revenue recovery, ultimately driving stronger revenue cycle performance and a stronger cash yield.
