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Case studies / Healthcare

Case Study: Simple Fractal Transforms Financial Operations for National ABA Provider

Posting 70,000 Checks in 3.5 Hours

Situation: A leading national ABA provider faced a significant challenge in managing its complex payer mix. Despite a dedicated team of 20 FTEs, the task of posting payments was overwhelming, with data integrity suffering and financial clarity diminishing. A backlog of 70,000 unposted insurance checks was accumulating, casting a shadow over the provider's financial operations.

Challenge: The provider's existing team, supplemented by contractors and consultants, could not keep up with the volume of 835 transactions, leading to a critical lack of visibility into financial health. This situation left the organization without clear insights into received payments, pending collections, and denied claims, hindering strategic financial decisions.

Solution: In response to this growing issue, our team was engaged to develop and implement a digital labor solution. Through a comprehensive discovery process, we gained an in-depth understanding of the provider's cash reconciliation practices, matching procedures, posting logic, and denial management. This allowed us to design a bot that could autonomously parse and post payments with impeccable accuracy.

Twist: The solution was a success, but the provider still faced the daunting backlog of 70,000 checks. At their request, we deployed our bot to tackle this historical data. To everyone's amazement, the bot replicated itself hundreds of times, processing the entire backlog in under four hours — a task that would have been impossible for human teams to achieve in the same timeframe.

Impact: A third-party consultant's assessment revealed that our digital labor solution resulted in a 90% reduction in FTE requirements. Furthermore, it unearthed $800,000 in unbilled services, safeguarding revenues against timely filing limits. In the first year following implementation, the provider saved $2.7 million. Over five years, the return on investment (ROI) soared to an impressive 13X.

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