Large-sized multi-specialty healthcare provider got $16M ACV engagement for the first 12 months

100K

Registered Users

193M+

Lives Supported

864B+

Billed Claim Value Processed (Annually)

5/5

Top US healthcare payers

4K+

Registered RCM Companies

400+

Plans Served

15.7 M

Charts Coded (Annually)

$4B+

Under Payment Identified

50K+

Medical Lockboxes

40+

Years of 
experience

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Sushil Ghorpade

Overview

A large multi-specialty healthcare provider in Texas faced numerous challenges, including unprocessed claims, high-volume B2B payments, and work backlogs. Seeking a comprehensive solution, they turned to PCH Health Solutions to revolutionize their operations.

Challenge

  • Numerous claims waiting to be processed
  • High-volume unprocessed B2B payments
  • Work backlogs, flawed workflows, and delays in work
  • Multiple handoffs for payments and claims
  • Ineffective payment and claim processing system

PCH Health Solutions

PCH Health provided the client with a one-stop solution to process payments and claims:

  • Utilized PCH Health's payment processing platform, TMS, to deposit checks received by customers, instantly reducing the TAT for deposits.
  • Processed Explanations of Benefits (EOBs) were using PCH Health to generate 835 automated files.

Results & Benefits

  • Reduced the client's TATs using our augmented payment and claims processing solution.
  • Developed resiliency for the client using PCh Health's hub-and-spoke model to support the new process, avoiding adverse impacts with a robust DR solution.
  • Reduced handoffs between deposits and reconciliation.
  • Achieved same-day deposits.
  • Completed reconciliation within 48 hours.
  • Processed exclusive volumes for the organization, amounting to a $16 million ACV engagement for the next 12 months.
  • Achieved significant scalability using a fully variable solution model.
  • Gained access to an extensive set of platform tools.
  • Offered customers add-ons to up-sell products and services, benefitting the end customer.
  • Reduced efforts for all stakeholders – the Payer, the Provider, and the Bank.

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