Case Study: Prospect Medical Holdings achieves lower denial rates and $10M less denied dollars with TransUnion

How Prospect Medical Eased Their Revenue Cycle Growing Pains

Prospect Medical Holdings, a growing regional healthcare provider, faced major revenue cycle challenges after expanding from 10 to 17 hospitals and inheriting multiple patient accounting, billing, and vendor systems. The lack of consistent reporting, communication, and denial tracking made it difficult to identify true claim denials, prioritize revenue recovery, and align teams around the same definitions and workflows.

To address this, Prospect Medical partnered with TransUnion Healthcare and used its A/R recovery Software-as-a-Service solution to better identify real denials and focus on dollars truly at risk. With TransUnion’s help, Prospect reduced inpatient denial rates from 17.2% to 13.6% and outpatient denial rates from 7.1% to 5.0%, cut net denied dollars by 21%, avoided 300-500 denials per month, and saved one facility $3 million in a year.

Prospect Medical Holdings

Ryan Bayne

Corporate Vice President of Analytics