Case Study: Legacy Health System achieves revenue protection and streamlined claims audit management with SAI Global's Claims Auditor

Legacy Health System - Customer Case Study

Legacy Health System, a Portland‑area non‑profit hospital system with five hospitals and over 1,700 beds, faced increasing revenue and compliance risk from aggressive Recovery Audit Contractor (RAC) and other post‑payment audits. After determining that point solutions couldn’t meet their needs, Legacy Health System selected SAI Global’s Claims Auditor to centralize and automate tracking and appeals for RAC, MIC, MAC, CERT, PERM, ZPIC and commercial payor audits.

SAI Global implemented Claims Auditor (project kicked off June 15, 2009 and went live August 1, 2009), giving Legacy Health System an automated “virtual audit coordinator” that enforces deadlines, routes tasks, and generates alerts. The system has managed more than 300 record requests to date, improved coordination so refunds and rebills aren’t processed prematurely, helped catch duplicate requests and missed‑deadline opportunities, and is now used to manage state Medicaid audits — delivering greater visibility and measurable reductions in manual monitoring.

Legacy Health System

Monica Freedle

RAC Coordinator