Case Study: State of Franklin Healthcare Associates expedites A/R by 13% and eliminates rework with Experian Health Claim Scrubber (Experian)

Robust claim scrubbing rectifies underpayments and eliminates rework

State of Franklin Healthcare Associates (SoFHA) is a multi‑specialty medical group with 109 providers, four clinical sites, a central lab and a sleep center in Johnson City, Tenn. The organization struggled with high denial and rework rates, limited front‑end eligibility verification and claim edits, frequent contractual underpayments, and a large centralized claims staff that spent significant time cleaning up and resubmitting denied claims.

SoFHA implemented Experian Health Claim Scrubber—with customizable edits and a flat monthly price—paired with Contract Management, Eligibility & Benefits Verification and Payer Alerts to proactively validate claims and catch payer changes. The solution produced daily exception lists, prevented underpayments (including correcting routinely bundled lab charges), and enabled process changes across the department, resulting in a 13% reduction in A/R, reduced FTE needs even as claim volume grew, and faster, more predictable reimbursement.

State of Franklin Healthcare Associates

Amanda Clear

Director of Business Services