Case Study: Avera Health achieves $20.6M in accelerated cash flow with Waystar Claim Monitoring

Health system automates claim status queries to insurers’ web portals and improves cash flow by millions while reducing AR days

Avera Health, a leading integrated health system serving the upper Midwest, faced a growing backlog of outstanding claims after rapid expansion — staff were individually closing about 13,452 claims per year by manually calling payers or checking insurer portals, leaving unpaid accounts unresolved for weeks or months. To address this, Avera engaged Waystar and its Claim Monitoring solution to automate claim status verification and integrate with their MEDITECH environment.

Waystar implemented Claim Monitoring with RPA-driven web bots that automated status checks, removed over 80% of claims that didn’t need human intervention, and integrated results into Avera’s workflow. The solution accelerated cash flow by $20.6M in year one, raised claims worked per staff from 13,452 to 15,001, cut average AR days by 7, reduced Medicare >90-day accounts from 10% to 6% and Blue Cross >90-day accounts from 20% to 7%, and delivered $260,000 in annual FTE savings.

Avera Health

Mary Wickersham

Vice President of Central Business Office Services