Case Study: Community Health Systems achieves >99.5% clean claims and 25% reduction in accounts receivable days with Optum

Accurate Patient Registration Helps Drive Speed to Payment

Community Health Systems, a three‑hospital nonprofit system serving northwest Indiana, faced growing complexity in patient registration and needed cleaner claims and the ability to apply its own rules to reduce denials, rejections and returned statements. To address this, Community Health Systems implemented Optum’s Ahi QA registration software to verify patient information at the front end.

Optum’s solution moved many back‑end claim edits to registration, reinforced accuracy through score‑based evaluation, and integrated with the new Epic EMR workflow. The results included more than 99.5% clean claims (99.69% in December 2013), a roughly 25% reduction in days in accounts receivable to about 42.9 days, fewer returned mail and improved payer accuracy—demonstrating measurable revenue‑cycle improvement driven by Optum’s Ahi QA.

Community Health Systems

Karen Schneider

Regional Director of Patient Financial Services