Case Study: Sansum Clinic recovers $8M+ in revenue and boosts cash flow with Experian Health

Digging deep into payer contract details pays big dividends

Sansum Clinic, the largest non‑profit multi‑specialty physician group in Santa Barbara County (about 200 clinicians, 835 staff across 20+ locations), faced a strained revenue cycle: frequent payer underpayments, eligibility-related claim denials, poor up‑front patient collections, no centralized way to track payer policy changes, and limited resources for identifying and appealing underpayments.

By implementing Experian Health’s Contract Manager & Analysis, Patient Responsibility Pricer with Eligibility & Benefits Verification, and Payer Alerts, Sansum automated payer compliance monitoring, improved appeals and negotiations, and increased time‑of‑service collections. The clinic recovered ~$4M through 60,000+ successful appeals (98.5% recovery rate), added an estimated $8M to the bottom line, cut eligibility denials by 55% (saving ~$919,688), and reduced A/R days from 87 to 41 while improving patient satisfaction.

Sansum Clinic

Jennifer Thomas

Vice President, Revenue Cycle