Case Study: a mid-sized health insurance plan recovers $24M with Zymr’s AI-driven revenue cycle automation

a mid-sized health insurance plan recovers $24M with Zymr

The customer, a mid-sized health insurance plan, faced significant revenue leakage due to increasing claim denials and inefficient manual workflows for appeals. To address this reactive denial management process, the health plan partnered with Zymr to implement an AI-driven revenue cycle intelligence platform.

Zymr implemented an AI-powered solution featuring denial prediction models and automated appeals generation. This approach achieved a 91% denial prediction accuracy and allowed the health plan to shift to proactive revenue protection. As a result, Zymr helped the customer recover $24 million in revenue and achieve a 47% improvement in first-pass acceptance rates.