Case Study: Non-Profit Health System recovers $4M in annual Medicare reimbursements with Bottomline’s Epic-integrated Healthcare Privacy & Data Security (PDS) platform

Non-Profit Health System Recovers $4M Medicare Reimbursements Annually with Epic-Integrated Data Monitoring Platform

A large non-profit U.S. health system—serving 7 million visits annually with 50,000 caregivers across 10+ hospitals—was losing about $4M a year from recurring Medicare claim rejections. The root cause was surgical procedure misclassification in Epic: a pop-up warned users of mismatches but only logged clicks, not whether the patient classification was corrected, so errors surfaced days or weeks later and claims were denied.

The system implemented Bottomline’s Epic‑integrated Healthcare Privacy & Data Security (PDS) platform to capture full user activity, apply real‑time analytics and send alerts to billing and clinical teams before procedures. Within two weeks the team averaged six timely, zero‑false‑positive alerts per day, enabling corrections that recovered an estimated $4M in annual Medicare reimbursements and prompting other departments to review their Epic workflows.