Case Study: Scripps Clinic recovers $10.6M in underpayments and streamlines contract monitoring with Experian Health

Scripps Clinic - Customer Case Study

Scripps Clinic is a San Diego–based multi‑specialty group with more than 400 physicians across 50 specialties that was struggling to monitor payment performance across 35 payer contracts and over 2 million claims annually. Manual review couldn’t catch small but pervasive underpayments, leaving revenue unverified and making financial planning and contract negotiations difficult.

Scripps implemented Experian Health Contract Manager and Payer Alerts, modeling major contracts, training a dedicated appeals team, and automating line‑item payment verification and payer policy monitoring. The tools uncovered patterns of underpayment (for example, injectible medications and second surgeries), streamlined appeals, and enabled proactive contract analysis—resulting in $10.6 million recovered from March 2003–February 2012, faster appeals, fewer errors, and improved workflow efficiency.

Scripps Clinic

Tonja Henderson

Supervisor of Business Services, Reimbursement