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Claim Processing Speed Improved 38%

How we helped a regional medical practice consolidate data sources and automate ETL processes

38%
Faster Processing
3
Systems Consolidated
100%
Automated ETL

The Challenge

A regional medical practice with 12 physicians was struggling with fragmented data across three systems: their Electronic Health Records (EHR), billing platform, and insurance verification service. Claims processing required manual data entry across systems, leading to errors, delays, and staff frustration. The average claim took 8.5 days to process, impacting cash flow and patient satisfaction.

Our Solution

Data Consolidation

Built a centralized data warehouse that pulled information from all three systems into a unified dashboard

Automated ETL

Implemented nightly ETL processes to sync data automatically, eliminating manual data entry

Real-Time Dashboards

Created Power BI dashboards showing claim status, aging reports, and denial trends in real-time

Validation Rules

Implemented automated validation to catch errors before claims submission, reducing rejections by 52%

Results

  • Claim processing time reduced from 8.5 days to 5.3 days (38% improvement)
  • Manual data entry eliminated for 95% of claims
  • Staff time saved: 15 hours per week, reallocated to patient care
  • Error rate decreased by 52%, improving first-pass acceptance rate
  • Cash flow improved with faster reimbursements and better denial management

Technologies Used

SQL ServerPython ETLPower BIREST APIsAzure Data Factory
"The automated system has transformed how we handle claims. Our staff can now focus on patient care instead of data entry, and we're getting paid faster."

— Practice Manager, Regional Medical Group

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