Easterseals Central Illinois provides services to help children with developmental delays, disabilities, and other special needs reach their full potential.

Behind the scenes, they faced growing pressure on their revenue cycle operations. Extended A/R days were causing cash flow delays, while ABA claims were frequently denied due to manual errors in CPT codes, missing modifiers, and inconsistent payer-specific requirements. These complex rule checks required time-consuming manual edits and constant oversight.

The process was resource-intensive and resulted in a system that strained both resources and revenue.

Thoughtful AI implemented AI Agent CAM to automate primary claims processing. It was built around Easterseals’ specific workflows, with custom-designed automation that fit directly into their existing systems.

CAM verifies CPT codes and modifiers using AI, runs real-time compliance checks for payer-specific requirements, and processes each claim with minimal human input. Integration was seamless, requiring no disruption to Easterseals’ core infrastructure.