- Case Study
The Switch to DME: 40% More Claims in Half the Time
- The Problem
The Client
An Inc. 5000-ranked healthcare organization seeking to improve claims operations after months of limited progress with a large, established offshore vendor. After nearly a year of engagement with a well-known outsourcing firm, the client began exploring more agile partners to strengthen their RCM performance.
The Challenge
After months with a well-established offshore vendor, the client saw little progress in claims processing. Ramp-up was sluggish, and output failed to meet expectations. Despite significant onboarding time, basic claim workflows remained inconsistent, and teams lacked the adaptability to handle evolving processes. The vendor’s reporting provided only top-line volume metrics, offering no visibility into rejections, root causes, or performance breakdowns. Leadership flagged persistent knowledge gaps, communication lags, and an inability to scale with urgency. With rising pressure on RCM operations, the client launched a Champions Challenge to find a more capable and responsive partner.
Productivity Growth Over Baseline in 6 Months
More Claims per day Compared to Previous Vendor