Success Story

ProMedica’s
way forward

A 10-hospital healthcare network automates claim status + identifies hidden coverage

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5%

Top 5% rank in HB and PB
claim status of all Epic clients*

85%

HB claim status useful
response average

$9.94M

billable opportunity using
Coverage Detection

*Based on Epic Pulse score

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CHALLENGES

The journey to automate claim status
+ revenue cycle workflows

ProMedica set out to reduce manual claim status work and improve visibility across key
revenue cycle workflows, replacing inefficient processes with advanced automation
and scalable strategies to help staff focus on accounts requiring action.

Actions

Steps to smarter automation
+ more proactive RCM processes

ProMedica leverages Waystar’s advanced automation and expansive payer
connectivity to streamline claim status, improve workflow efficiency, and
strengthen front-end processes.

The smarter way
to status claims

ProMedica categorizes claim status responses by action, triggering automated next steps and removing resolved claims from queues to decrease administrative effort.

The faster way to streamline workflows

With greater visibility into claim status, teams reduce touchpoints, accelerate follow-up, and improve efficiency across workflows without increasing burden.

The better way
to verify coverage

Eligibility Verification and Coverage Detection surface accurate benefit details earlier and identify hidden coverage, helping teams strengthen front-end processes.

Get the full story

Learn how ProMedica improved claim status and captured more billable coverage opportunities.

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“When looking at claim status, there is only a very small portion of manual work because so much of it is being automated.”
Jim Seiwert, AVP, Consolidated Business Office, ProMedica

Results

Propelling their mission forward

By leveraging advanced automation, ProMedica has improved claim status
performance, maximized efficiency, and increased visibility across the revenue cycle.

5%

Top 5% rank in HB and PB claim status of all Epic clients*

85%

HB claim status useful response average

$9.94M

billable opportunity using Coverage Detection

80

new care
locations opened

60%

of auths obtained
automatically in first year

61%

Epic Pulse score for
authorization*
*Based on Epic Pulse score

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Discover how Waystar’s AI-powered platform and advanced automation capabilities can strengthen revenue cycle performance and reduce manual work across your healthcare organization.
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