Case Study: a mid-sized health plan achieves 91% denial prediction accuracy and recovers $24M with Zymr's AI revenue cycle automation

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

The customer, a mid-sized health plan, faced challenges with rising claim denials, delayed reimbursements, and limited visibility into denial patterns, which were impacting its financial performance. To address these issues, the health plan partnered with vendor Zymr for an AI-driven revenue cycle automation solution.

Zymr implemented an AI-powered platform featuring machine learning models for denial prediction and workflow automation. The solution achieved a 91% denial prediction accuracy and recovered $24 million across 4.1 million claims. Additional results included a 35% reduction in manual review effort and 28% faster denial resolution timelines.