Smart Eligibility Verification
real-time payer checks to reduce front-end errors
Chicago Infectious Disease Reduces Denials from 16% to 10%
How a 31-provider Illinois specialty practice cut denials by nearly 40%, lifted clean claim rate to 98%, and added $150K/month in revenue within 60 days — powered by AI-driven RCM and a dedicated billing team supported the engagement, with specialist review based on workflow needs.
Chicago Infectious Disease, a 31-provider specialty practice in Illinois, was not keeping revenue pace with its patient volume. Despite strong patient volume, the practice faced delayed reimbursements, a rising denial rate, and mounting operational strain, with administrative workload outpacing claim throughput and hurting cash flow.
Revenue Starts Slipping Through the Gaps
Before Dastify Solutions, the practice was dealing with:
Denial rate consistently around 16%
Clean claim rate around 88% — below industry benchmarks
Delayed AR follow-ups and inconsistent payer communication
Only 4 billing staff, fully engaged in manual claim processing and follow-ups
The core breakdown areas driving the problem:
Missing or incorrect patient eligibility verification
Coding inaccuracies and modifier mismatches
Incomplete documentation at submission
Delayed follow-ups on pending claims
A Fully Connected AI-Driven Revenue Cycle
Dastify Solutions deployed an integrated RPA + AI-powered RCM system combining automation, intelligent workflows, and certified billing expertise:
AI Claim Scrubbing Engine
Automated validation before submission
Agentic AI Monitoring
continuous claim tracking to prevent silent denials
Automated Payment Posting
ERA-based reconciliation
End-to-End Integration
connected EHR, EMR, PMS, clearinghouse, and SFTP workflows
Expert Billing Support
A dedicated billing team supported the engagement, with specialist review based on workflow needs
60-Day Transformation
- 01
Weeks 1–2
Eligibility verification and claim scrubbing rolled out — front-end errors reduced, submission accuracy improved
- 02
Weeks 3–4
Denials trended toward 10% as backlog claims were resolved through automated follow-ups
- 03
Weeks 5–6
AR stabilization completed with improved payer turnaround times and stronger clean claim performance
- 04
Day 60
System stabilized — denial rate at 10%, clean claim rate at 98%, monthly revenue at $550K
The Results
| Metric | Before | After | Improvement |
|---|---|---|---|
| Denial Rate | 16% | 10% | 37.5% decrease (6 percentage-point drop) |
| Clean Claim Rate | 88% | 98% | +10 percentage points |
| Monthly Revenue | $400,000 | $550,000 | +$150,000/month (+37.5%) |
| AR Days | High & unstable | Reduced & stabilized | Consistent, predictable cycles |
Clean claim rate reflects the last 3 months of performance data.
Key Takeaway
By combining AI-driven automation with expert-led RCM execution, Dastify Solutions helped Chicago Infectious Disease cut denials from 16% to 10%, lift clean claim rate from 88% to 98%, and add $150K/month in revenue — all within 60 days.
Stay Compliant. Stay Protected. Stay Paid.
Schedule a consultation with our RCM architects. We’ll audit your current cycle and show you exactly where revenue is being left behind.