Customer story
How NextGen RCM Services automated claim status across their entire client portfolio with Substrate ARC: Claim Status.
4x
claim status volume, same team
75%
lower cost per status
95%
claim status success rate
NextGen's RCM Services group manages billing for dozens of practice clients, each with its own NPIs, payers, and identifiers. Even as sophisticated users of the 276/277 EDI transaction, the team spent countless hours logging into portals and calling payers to status no-response claims. As volume grew, manual claim status became structurally unsustainable.
01
Before any request, it checks what worked for similar claims, by payer, client, and state, and starts from accumulated knowledge instead of a blank slate.
02
Different errors mean different things. The agent reads the signal and picks its next attempt accordingly, instead of marking the claim failed after one try.
03
When a combination of NPI, payer ID, and demographics produces a result, it records the pattern. Accuracy compounds as volume grows.
“Deploying the Substrate Claim Status AI agent enabled us to handle 4x the volume with the same team.”
Lance Merkley
VP RCMS Technical Services, NextGen RCM Services
Talk to us and we'll show you the routing, the success rate, and the worklist write-back on your payers.
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