A Leading US Hospital’s Data Approach

How a top-tier healthcare provider used AI-powered data quality to lower denials, recover revenue, and streamline patient records

Background:

A prestigious Magnet Hospital in the United States, known for its clinical excellence and strong financial operations, was experiencing a higher-than-benchmark claim denial rate. Despite delivering critical services, missing or inaccurate data in patient encounter records led to significant revenue leakage and operational inefficiencies.

Key issues included:

• 🩺 Incomplete or incorrect patient data

• ❌ Missing claim submission details

• 🔄 Mismatch between clinical and financial systems

  
  

These gaps hindered billing accuracy and delayed revenue collection—prompting the leadership team to find a scalable, proactive solution.

The Challenge:

The hospital’s revenue cycle team was struggling with:

• 📄 Services delivered without all required claim submission data

• 📉 High claim rejection due to data discrepancies

• 🧩 Fragmented records across clinical and billing systems

• 🚫 Lack of real-time visibility into data errors before submission

Solution: Routine Powers Clean, Consistent Customer Data

The hospital implemented Routine as an autonomous data quality solution to uncover and resolve issues hidden deep within patient records and system integrations.

🔍 Rapid Data Evaluation

Routine scanned patient encounter records across systems and identified:

• $5M in incomplete or inaccurate claims in a single quarter

• Gaps in patient info, service codes, and insurance data

• Mismatches between financial and clinical entries

🧠 Automated Rule Identification

Routine auto-generated rules for anomaly detection—flagging records that didn’t meet submission standards and offering insights on corrective actions.

🔄 Process Optimization Insights

In addition to cleaning existing data, Routine surfaced systemic process inefficiencies that contributed to recurring data issues, enabling the hospital to make long-term fixes.

Results:

✅ 30% Reduction in Claim Denials

Fewer rejections meant faster reimbursement cycles and improved cash flow.

⏱️ 10-Day Impact Timeline

Routine delivered measurable results and insights within 10 business days of deployment.

⚙️ No Technical Disruption

The platform seamlessly integrated with the hospital’s systems—no heavy IT lift required.

💰 Revenue Recovery and Retention

By cleaning and validating data proactively, the hospital plugged revenue leaks and improved overall billing accuracy.

Conclusion:

For modern healthcare providers, clean data is critical to financial health. This Magnet Hospital’s experience proves that operational transformation can start with fixing the fundamentals. With Routine, they quickly reduced claim denials, uncovered millions in revenue risk, and empowered teams with data they could trust.

📌 Struggling with denied claims or data mismatches? 📅 Schedule a Demo with us and reduce revenue leakage today.