From Crisis to Momentum: How Access Healthcare Transformed Denial Management for a Texas Health System
Recently, the finance team at a major Texas hospital system gathered in a conference room. The numbers on the screen were sobering. Denials had spiked to 20 percent, aging claims were piling up, and each passing day brought more financial pressure to keep the doors open for patients who need them most. That’s when they turned to Access Healthcare.
What started as a modest engagement soon became a catalyst for sweeping change, reversing denial trends and driving sustainable operational improvements.
Mounting Challenges and a Shrinking Window for Action
Behind every denial is a patient waiting for care, a clinician frustrated by paperwork, and a team stretched to the breaking point. Accounts receivable days were rising, underpayments were becoming the norm, and denial rates had spiked to a staggering 20 percent. Digging deeper, the root causes became clear:
Credentialing breakdowns with major payers
Missing documentation
Authorization lapses
Complex coding rejections
Internal teams were exhausted and leadership faced a tough choice: cut back on outside help and risk deeper losses or try something bold.
That’s when Access Healthcare stepped in—not with a band-aid, but with a blueprint.
The Turning Point: Data Meets Determination
Instead of accepting a reduced scope, we rolled up our sleeves and launched a full-spectrum review, zeroing in on high-value claims and those racing toward deadlines. Our analytics team didn’t just crunch numbers; we realized they told a story. The data revealed exactly where the process was breaking down. Each denial was meticulously categorized, transforming raw data into clear, actionable insights.
But the real magic happened in the trenches. Revenue cycle partners, coding experts, and front-line staff joined forces to tackle backlogged denials and embed preventative measures into daily workflows. These celebrated small wins became huge momentum boosters. Automation bots worked around the clock to flag exceptions before they became problems, ensuring faster processing and fewer delays.
Meaningful, Measurable Impact Within 90 Days
The transformation was dramatic:
Denial rates fell from 20 to 11 percent—a level not seen in years.
Collections jumped-up by $5.2 million, enough to fund critical programs and staff bonuses.
Aging claims shrank, freeing up cash flow and reducing stress for everyone involved.
New tools for appeals, paper claims, and automation set the stage for ongoing success.
The Takeaway: Partnership Powers Progress
This wasn’t just a turnaround; it was a transformation. By combining deep expertise with relentless collaboration, Access Healthcare helped the Texas health system move from crisis mode to a new era of confidence and growth.
If your organization is facing similar challenges, let’s talk. Together, we can turn obstacles into momentum.
“This wasn’t just about working claims. It was about understanding the data to uncover what was really holding revenue back. We turned what looked like a year-end collection crisis into a success story.”