Case Study: a healthcare RCM operator reduces cost-per-claim and days in AR with Reliable Group's COPO AI layer

RCM cuts cost-per-claim 35% to 45% with Reliable Group

The customer, a healthcare RCM operator, faced the "Level 2 Trap" where using an external AI vendor would risk leaking institutional knowledge and patterns to a third party's platform. Their challenge was to implement AI to reduce costs without sacrificing ownership of their proprietary data and operational residue. They partnered with Reliable Group to address this.

Reliable Group implemented a two-lever solution using their Blueprint. This involved deploying Virtual Employees within the operator's own data boundary and establishing a senior team inside the operator's COPO entity. The results after twelve months included a 35-45% reduction in cost-per-claim, an 18-25% reduction in days-in-AR, and a 30-40% reduction in denials rework. Critically, all institutional knowledge and AI capability compounded on the operator's own balance sheet, increasing enterprise value.

RCM