Easterseals Central Illinois struggled with high Days in A/R and frequent ABA claim denials due to unfiled claims with issues like missing modifiers and incorrect CPT codes. Manual errors in the RCM process led to growing inefficiencies and delays.

Certain payers had very specific rules which led to burdensome manual edits and workflows that were susceptible to human errors, leading to high denial rates.

The Thoughtful team comprehensively examined current workflow process and then crafted a bespoke implementation strategy tailored to the needs of Easterseals Central Illinois. Thoughtful’s AI Agents automated the Primary Claims process and removed all human errors. AI Agents enhanced compliance with payer-specific rules, reducing the manual burden and error rates associated with claim submissions.

AI Agents reduced the primary denials by 7% on average and brought the ABA claim denials down to less than 2%. Easterseals Central Illinois significantly decreased time spent on low-level but high-risk billing issues, allowing the team to focus on high-impact RCM improvements.