Claim Follow-Up

Claim follow-up that keeps revenue moving.

Earnest went live in six weeks for a multi-specialty MSO, working across every major payer and adapting to each carrier's systems, rules, and denial patterns while returning thousands of biller hours.

$10.64M

Billed claim value worked

2,859

FTE-hours of calling saved in the first two weeks

$2.1M

Cash flow unlocked through faster claim resolution

34 min

Average hold time removed per AI-handled call

Snapshot

Customer: Multi-specialty MSO group
Setting: High volume across every major commercial payer
Time to Go-Live: 6 weeks

The Challenge

A large, multi-specialty MSO group was struggling to manage ballooning AR. The book spanned every major commercial payer, each with a different portal, different representatives, different denial logic, and different hold times. BCBS had the longest hold time at roughly 46 minutes per call. Working every payer at volume consumed most of the team's bandwidth, preventing billers from focusing on higher-leverage tasks, such as working directly with providers or identifying patterns in documentation errors.

The Solution

Earnest's AI worked claims across every major payer, navigating each carrier's systems, waiting out holds, and capturing the status, denial reason, and next step in one consistent format. On average, the AI absorbed 34 minutes of payer call time that would otherwise have required a human agent, returning 2,859 FTE-hours to the billing team in the first two weeks alone. The AI followed the team's exact SOPs and revisited claims at regular intervals more consistently than a human team could. As Earnest's AI worked more claims, it identified patterns in payer reimbursement and learned the most effective path for resolving each denial.

The Results