MARY B.
Healthcare / Medical Billing — USA
Client Profile
Industry
Healthcare / Medical Billing Services (USA)
Size
Processes 18,500+ claims monthly for 85 clinics
Business Model
$4.50 per processed claim, $83K
MRR
Challenge
Handwritten prescriptions, high
rejection rates
Business Problem
→ 320+ hours weekly spent on manual data entry
→ 18.5% claim rejection rate costing $165K annually
→ 9.2-day processing backlog impacting clinic cash flow
→ No audit trail for claim edits
→ Manual verification limiting growth
Objective
Transform lead generation:
Reduce claim processing to under 24 hours
Achieve 90%+ first-submission acceptance
Cut cost per claim by 60%
Scale to 250+ clinics without proportional hiring
Ensure full audit and compliance visibility
Automation Details
Multi-channel
Multi-channel document intake
Pre-processing
Image pre-processing for OCR accuracy
Hybrid
Hybrid OCR ensemble processing
Medical code
Medical code mapping engine
layer
7-stage validation layer
Auto-correction
Auto-correction and smart resubmission
Audit trail
Complete audit trail and versioning
Solution Overview
→ End-to-end OCR automation for medical billing
→ Handwriting recognition trained on 50K+
prescriptions
→ Extraction of ICD-10, CPT, patient & billing data
→ Automated claim submission and resubmission logic
→ Predictive rejection detection and dashboards
Technology Stack
Frontend
AWS Textract Medical, Azure Form
Recognizer
Backend
Django REST, Celery
Database
MySQL, Redis
ML
TensorFlow handwriting models
OCR/AI
dhtmlxGantt for interactive timelines
Infrastructure
AWS Auto Scaling
Integrations
Insurance portals, HL7/FHIR
Outcome & Impact
→ Processing time reduced from 9.2 days to 18 hours
→ First-submission acceptance increased to 94%
→ Cost per claim reduced from $4.50 to $1.80
→ Monthly revenue increased from $83K to $267K
→ Zero client churn post-automation
Why This Matters for Similar Clients
Billing companies double capacity without cost
explosion
Clinics receive faster reimbursements
RCM providers reduce rejections before submission
Healthcare networks maintain compliance at scale
Billing startups scale without rebuilding systems
ROI achieved in 5–7 months
Faster Claim Processing
Acceptance Rate
Revenue Growth