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Case Study • Infectious Disease

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 team of 500+ certified billing specialists.

Chicago Infectious Disease, a 31-provider specialty practice in Illinois, was processing 8,000+ claims per month — but revenue wasn’t keeping pace. 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.

The Challenge

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
  • Over 2,000 claims aging toward filing expiration
  • 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
The Solution

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:

Smart Eligibility Verification

real-time payer checks to reduce front-end errors

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

500+ certified professionals ensuring coding accuracy and payer compliance

From Pending to Paid

60-Day Transformation

Weeks 1–2

Eligibility verification and claim scrubbing rolled out — front-end errors reduced, submission accuracy improved

Weeks 3–4

Denials trended toward 10% as backlog claims were resolved through automated follow-ups

Weeks 5–6

AR stabilization completed with improved payer turnaround times and stronger clean claim performance

Day 60

System stabilized — denial rate at 10%, clean claim rate at 98%, monthly revenue at $550K

Impact

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.
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