Atlantic Care Partners

Background

Atlantic Care Partners is a 42-provider multi-specialty group operating across 6 locations in the Mid-Atlantic region. The practice spans family medicine, internal medicine, cardiology, and endocrinology, processing approximately 85,000 claims annually across 22 payer contracts.

The Challenge

Eligibility verification errors had become the single largest driver of preventable denials. With patients frequently changing insurance — particularly in the post-exchange enrollment landscape — front-desk staff were unable to consistently verify coverage accuracy across all locations.

The impact was significant: 35% of all front-end denials were attributed to eligibility errors. Manual re-verification was time-consuming and inconsistent. Multi-visit patients with changing coverage were particularly problematic. Rework costs — including re-billing, patient communication, and appeals — exceeded $1.8M annually.

The RevsynAI Intervention

RevsynAI deployed real-time eligibility intelligence integrated directly with the practice's scheduling and registration workflows across all 6 locations. The system continuously validates coverage data against payer databases, flags discrepancies before claims are generated, and automates re-verification for patients with upcoming appointments.

Key capabilities deployed included: automated batch re-verification 48 hours before each scheduled appointment, real-time coverage change alerts triggered by payer data updates, coordination of benefits detection for patients with multiple coverage sources, and patient financial responsibility estimation based on verified benefit details.

Implementation Timeline

Integration with the practice's eClinicalWorks EHR was completed in 18 days. Parallel operation ran for 2 weeks alongside existing manual verification workflows. Full autonomous operation began at Week 5.

Results (First 90 Days)

Denial reduction met the 22% target within the first 90 days, driven almost entirely by the elimination of eligibility-related front-end denials. Annual rework cost savings were validated at $1.8M through comparison of pre- and post-deployment denial volumes. The practice achieved measurable ROI within 60 days of go-live — faster than the projected 90-day timeline.

Secondary benefits included improved patient satisfaction (fewer surprise bills), reduced registration time per patient, and enhanced visibility into coverage patterns across the patient population.