Case Study

Avera Health

Avera Health

Pages 2 Pages

The challenge As one of the leading integrated health systems in the upper Midwest, Avera Health cares for hundreds of thousands of patients across dozens of hospitals in South Dakota and significant areas of Minnesota, Iowa and Nebraska. Due to rapid growth, outstanding claims had steadily increased, creating a persistent backlog for staff to wade through. As of 2016, staff were individually tasked with closing 13,452 claims per year. To do so, they relied on phone calls with payers or visiting websites to hunt down a claim’s status. With either approach, staff had to manually log the status into their workflow system. In response, Avera’s Vice President of Central Business Office Services Mary Wickersham decided to reinvent how her department verifies claim approval. “My staff

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