Streamlined Medical Billing at Regional Hospital System
How DataConvertPro helped this healthcare organization streamline document processing and improve operational efficiency.
The Challenge
St. Joseph Regional Hospital's billing department processed 8,000+ patient invoices monthly, with each invoice requiring manual extraction of patient demographics, insurance information, and service details from scanned PDFs and paper forms. Staff spent 120 hours/week on data entry, transcription errors led to claim rejections (12% rejection rate), and billing cycles stretched to 45+ days. Insurance companies frequently requested claim corrections due to missing or inaccurate information, causing revenue delays and increasing accounting labor. The hospital was leaving $500K+ annually on the table due to slow billing cycles and rejected claims.
The Solution
DataConvertPro was deployed to automate the entire medical billing intake process. The platform extracted patient information, insurance details, diagnosis/procedure codes, and service line items from diverse source documents (insurance claim forms, intake sheets, surgical reports, ER visit documentation). Machine learning models were trained on the hospital's historical data to recognize institutional patterns and coding conventions. Automated validation flagged discrepancies and missing required fields before submission to insurance carriers. Integration with their Epic EHR system enabled real-time claim submission, with only complex or flagged cases requiring manual review.
Before & After
Before: Manual PDF Processing
After: DataConvertPro Extraction
| Date of Service | CPT Code | Description | Billed | Insurance | Adjustment | Patient Owes |
|---|---|---|---|---|---|---|
| 01/15/2024 | 99213 | Office visit, est. | $185.00 | $140.00 | $21.00 | $24.00 |
| 01/15/2024 | 70450 | CT head w/o contrast | $2,450.00 | $1,850.00 | -$370.00 | $0.00 |
| 01/15/2024 | 93000 | Electrocardiogram | $175.00 | $120.00 | -$55.00 | $24.00 |
| 01/16/2024 | 80053 | Comprehensive metabolic panel | $320.00 | $240.00 | $0.00 | $80.00 |
| 01/16/2024 | 99285 | ED visit, high complexity | $1,250.00 | $950.00 | -$95.00 | $395.00 |
| TOTALS | $4,380.00 | $3,300.00 | -$499.00 | $523.00 | ||
The Results
Reduced billing department manual data entry time from 120 to 18 hours/week (85% reduction)
Claims rejection rate dropped from 12% to 1.3%, saving 700+ claims per month from rework
Average billing cycle accelerated from 45 days to 12 days
Revenue recognition improved by $620K annually through faster claim processing and fewer rejections
Patient billing inquiries decreased by 68% due to fewer errors and clearer communications
Staff was redeployed to high-value tasks: insurance appeals, complex claim negotiations, patient advocacy
Client Testimonial
“The impact on our revenue cycle has been transformative. We're now collecting payments faster, claims are getting approved on the first submission, and our billing team has gone from being buried in paperwork to actually managing our relationships with insurance carriers. This directly improved our bottom line by over half a million dollars.”