Easterseals Central Illinois’s Success with Thoughtful AI

Easterseals Central Illinois faced significant challenges in their revenue cycle management process that were impacting their ability to serve families effectively. High accounts receivable days, claim denials, and burdensome manual processes were creating bottlenecks in their operations and affecting their bottom line.

The organization struggled with several critical issues in their RCM workflow:

• Extended A/R days causing cash flow delays
• High frequency of ABA claim denials
• Manual errors in CPT codes and missing modifiers
• Complex payer-specific rules requiring time-consuming manual edits
• Resource-intensive processes pulling staff away from higher-value activities

Thoughtful AI implemented a comprehensive solution to automate and streamline primary claims processing. The implementation included:

• Custom-designed automation workflows aligned with Easterseals' specific needs
• AI-powered verification of CPT codes and modifiers
• Compliance checks for payer-specific requirements
• Seamless integration with existing systems