Case Study: a leading national healthcare provider achieves cleaner, faster claims processing with Simple Fractal RPA

How we helped automate 90% of the billing function

A leading national healthcare provider faced significant inefficiencies in its manual claims processing, grappling with high workloads, delayed payments, and scalability issues due to a complex payor mix. To address these challenges, they partnered with Simple Fractal to implement a Robotic Process Automation (RPA) solution aimed at revolutionizing their claims scrubbing process.

Simple Fractal deployed its digital labor solution to automate the scrubbing of every data point on a claim against 57 payor plans, ensuring clean, compliant claims were sent out on the first pass. This implementation resulted in a 90% reduction in FTE requirements and processed 520,000 claims with 30% growth and no increase in overhead. The solution also preempted denials and significantly increased accuracy, achieving a 10X return on investment for the healthcare provider.