Case Study: a large multi-facility health system reduces manual claim reviews with RSM US LLP's secure automation

a large multi-facility health system cuts manual claim status checks by 95% with RSM US LLP

A large multi-facility health system faced significant security and operational challenges due to its reliance on a third-party clearinghouse for claim status reviews. This dependency created risks of downtime and data breaches, while manual checks of payer portals slowed reimbursements and increased errors. The health system turned to RSM US LLP for a solution, which was built using Microsoft Azure services.

RSM US LLP designed and implemented a secure, Azure-native automation solution to directly retrieve claim statuses from payers and integrate them into the client's Epic system. This eliminated $1.3 million in annual third-party costs and reduced manual claim status checks by over 95%, saving an estimated 20,000 labor hours per year. The solution also provided a scalable foundation for future AI capabilities while significantly boosting security with Azure-native controls.