Case Study: Guidehouse reduces $44M in payer denials and reclaims 2,000+ employee hours with Automation Anywhere

Conversational AI and Intelligent Automation Reduce Payer Denials, Improve Employee Efficiency

Guidehouse, a global consulting and managed-services firm, was engaged by a large health system suffering millions in insurance claim denials and heavy employee rework across 13 business functions. The client’s ineffective processes and high first-pass denials were creating significant revenue loss and operational strain.

Using Automation Anywhere’s Process Discovery with subject-matter experts, Guidehouse captured more than 1 million activities in two weeks, identified root causes (such as incorrect payer information), and deployed conversational AI plus RPA to verify eligibility and automate updates. The work impacted over $44 million in denied accounts, returned more than 2,000 hours to employees, and revealed seven additional automation opportunities.

Guidehouse

Michael Duke

Partner - Commercial Healthcare