Case Study: Wallace Thomson Hospital achieves streamlined claims management and recovered reimbursements with Optum (RelayAssurance & RelayClearance)

RelayAssurance and RelayClearance Combine to Help Small Hospital Deliver Big Results

Wallace Thomson Hospital, a small not-for-profit community hospital serving Union County, SC, faced high self-pay volume, largely manual patient access and revenue-cycle processes, and limited visibility into CPT code changes and claim status. To address these challenges, Wallace Thomson Hospital engaged Optum and implemented RelayAssurance and RelayClearance to automate claim quality checks and eligibility verification.

Optum’s RelayAssurance provided automated claim edits, denial reporting and routing so staff could quickly identify and correct errors, and RelayClearance automated eligibility checks and Propensity to Pay assessments for charity applications. Within weeks Optum’s solution revealed a previously unknown CPT coding issue that had left Magnetic Resonance Angiography (MRA) claims unpaid, while overall workflows became more efficient, manual touchpoints were reduced, claims management was streamlined, and charity eligibility decisions were improved.

Wallace Thomson Hospital

Roger Miller

Director of Revenue Cycle