CorroHealth Partnership Leads to $583 Million Revenue Recovery for 11-Hospital Health System

Overview

Operating a vast health network is no small feat, let alone achieving excellence across the board. However, one prominent non-profit hospital system in the American Midwest manages to do just that. With nearly a dozen hospitals, over 2,500 beds, and a workforce of 30,000, this healthcare giant is recognized as a top healthcare system in America, generating billions in net revenue annually. Yet, the health system was overwhelmed by backlogs of aged accounts receivable stemming from denied claims with limited human resources to work them.

The Challenge

A critical challenge emerged while transitioning to a new Electronic Health Records (EHR) system. The organization faced a significant resource strain as it grappled with millions of dollars in aged accounts backlogged on the old system. This required attention during the transition period to avoid compounding issues such as increasing claim denials, which put more pressure on its workforce and threatened its financial health.

The Solution

The health system partnered with CorroHealth, which provided critical technological and strategic revenue cycle solutions to streamline recovery and supplement human resource challenges. A detailed analysis of the $71 million aged account inventory showed $9 million of that in self-pay, $22.4 million in contractual adjustments, and $10.7 million was re-directed to the appropriate departments for immediate resolution. CorroHealth pledged to compliantly recover $20 million in cash from that inventory.

“Partnering with a qualified third party to resolve legacy AR enabled internal staff to focus exclusively on the new billing platform,” said the Hospital System’s CFO. “For our health system, this practice has generated major benefits, both in terms of more effective conversions and improved collection of old AR.”

The successful AR conversion project unfolded in stages. This progressive approach helped to minimize hospital costs by deferring the outsourcing of claims less than 30 days old, thereby avoiding further AR backlog. CorroHealth delivered on its promise, generating $20 million in cash from $28 million in net placements, achieving a net collection rate of 70%. CorroHealth accomplished its goal by leveraging PRISM Enterprise RCM Technology™, its proprietary AI-optimized revenue recovery platform.

PRISM automatically organizes large claims volumes by dollar value, complexity, and claim age. This intelligent technology assigns claims to AR recovery team members based on expertise, value, and complexity. It also identifies the payers most likely to pay through data-driven scoring. This results in a streamlined, up-to-date, and effective workflow that improves efficiency and revenue cycle outcomes.

Solving Ongoing Challenges Through Partnership

After successfully managing the conversion wind-down project, CorroHealth began handling more of the health system’s aged accounts, leading to a long-standing 10-year partnership.

“CorroHealth is a valued partner in our revenue cycle strategic plan,” said the Hospital System’s CFO. “They handle our small-balance claims accounts across commercial, Medicare Advantage, Medicaid Managed Care, aged accounts, conversion wind-down projects, as well as other strategic projects.”

Today, CorroHealth begins managing claims when they are over 30 days outstanding and under $1,200. Claims exceeding $1,200 are addressed on day 90, and those associated with hard denials—complex cases related to medical necessity, lack of authorization, or non-covered benefits—are handled on day 15. This structured approach allows the hospital staff to concentrate on more recent, higher-value claims, optimizing internal resources and reducing outsourcing costs.

Furthermore, CorroHealth supports the health system’s registered nurses by managing clinical appeals and employs a hybrid onshore/offshore staffing model to tackle ongoing human resource challenges.

 Long-Term Results

The partnership’s impact is significant. Since the collaboration began in 2013, CorroHealth has managed over 1.2 million claims, totaling $1.4 billion. The company has successfully resolved $1.35 billion in inventory, achieving an 80% net collection rate on resolved inventory. Additionally, CorroHealth recouped $583 million in cash, applied $262 million in contractual adjustments to the EHR, and identified $104 million in patient balances.

“I’ve been working with CorroHealth for over ten years,” stated the CFO of the Hospital System. “Thanks to their exceptional performance, they’ve become a key partner in our strategic revenue cycle plan, helping us aim for 100% insurance reimbursement.”

 This long-standing collaboration demonstrates the value of a strategic partnership with solutions that utilize intelligent technology and revenue cycle expertise. Together, the health system and CorroHealth have significantly improved the hospital’s financial operations. Their teamwork solved immediate AR recovery backlogs and helped prevent future workforce and financial issues.

Whether you want to learn more or you are ready to get started, let’s talk.