Case Study: a leading non-profit healthcare system accelerates eligibility and prior authorization with Profisee

Leading Non-Profit Healthcare System cuts erroneous matches by 60% with Profisee

A leading non-profit healthcare system faced significant challenges in verifying patient eligibility and obtaining prior authorizations, especially for vulnerable populations with inconsistent data. Their fragmented patient and payer information, spread across multiple systems, resulted in manual effort, delayed submissions, and slower care delivery. To address this, they expanded their use of the Profisee MDM platform to automate the consolidation and validation of this critical data.

By deploying a dedicated Profisee instance for patient and member data, the healthcare system gained intelligent, multi-step matching capabilities to accurately link records across multiple coverage changes. This solution reduced erroneous matches by 60% and saved 5-10 minutes per case. The efficiency gains were substantial, as each team member could process 12-14 claims per hour—a fourfold increase in throughput—enabling faster, more compliant care delivery.