Case Study: ProHealth Care achieves lower denials and stronger revenue cycle performance with Inovalon RCM Intelligence

ProHealth Care cuts denial rate below 5% with Inovalon

ProHealth Care, a multi-location health system in Wisconsin, faced significant revenue cycle underperformance due to a high volume of claim denials. Without robust analytics, they struggled to identify the root causes, leading to increased accounts receivable days and write-offs. They turned to Inovalon and its RCM Intelligence platform to gain better insights into their denial patterns.

By implementing Inovalon's RCM Intelligence, ProHealth gained access to interactive dashboards that provided daily, actionable data. This allowed them to quickly identify denial root causes and make upstream corrections. As a result, ProHealth now achieves a 90-95% clean claims rate on first submission, reduced its overall denial rate to under 5%, and saved hundreds of thousands of dollars annually on analytics costs, significantly improving their financial performance.

ProHealth Care