Intelligent Automation Case Studies

Our Case Studies

At Four Point Health, we believe in a future where healthcare is not just a service but a seamless, empowering experience. Our innovative solutions, using intelligent automation, are designed to revolutionize the way healthcare is delivered, with a human centric approach to enhance efficiency, accuracy, and patient outcomes. Here is a glimpse into some impactful use cases that define our commitment to improving the delivery of healthcare:

Credentialing And Enrollment

Client was experiencing an increase in denials from missing or incorrect physician credentialling and plan enrollment largely due to increased physician turnover.

  • $9.5M Value
  • Reduced Labor Costs
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Claim Status & Response

Large mid-west regional healthcare system needed to increase the frequency and efficiency of claim status checks and the resulting responses.

  • $13.2M+ Value
  • Increased Speed To Cash
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Pre-Authorization Automation

$8B Mid West healthcare system manually processing 1.6M pre-authorizations annually wanted to automate its pre-authorization processes with the following objectives:

  • $9.5M Value
  • Reduced Labor Costs
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Risk-Based Care Management

To improve high-risk pregnancy outcomes Client asked Four Points to re-write their risk prediction model.

  • $22.7M+ Saved
  • FTE Cost Reduction
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Credit Balance Clearing

75 FTEs were working Credit Balances daily across HB & PB accounts totaling more than $43M in credit balances.

  • $4.2M Value
  • Cost Reduction & Penalty Avoidance
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Eligibility & Benefits Verification

Client needed to streamline EBV processes across multiple regions and separate EHRs.

  • $11.8M Value
  • FTE Reduction & Revenue Increase
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Patient Outreach

Nurses were spending 2.5 hours/day entering patient notes into Care Management system following outreach sessions.

  • $12.3M Value
  • Increased Patient Retention, Increased Patient Capacity, Lowered Healthcare Providers Costs
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Referral Management

A consistent lack of referral capture was creating significant backlog in claim processing.

  • $5.6M Value
  • FTE Reduction & Speed To Cash
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Remittance Posting

An 80-person team was manually processing remittance postings everyday and client needed to reduce the huge backlog.

  • $3.2M Value
  • FTE Reinvestment
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Talent Acquisition

The nursing shortage and turnover significantly increased Client’s TA efforts to 90k candidate reviews annually.

  • $14M Value
  • Replacement Cost & Onboarding Cost Reductions
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