On this episode of Business Ninjas Podcast, MedEvolve CEO Matt Seefeld breaks down where these leaks happen and how providers can seal them off.
Healthcare providers face a perfect storm: rising costs, shrinking reimbursements, and increasing claim denials. Traditional billing systems were built to push claims out the door, not to measure staff effectiveness or reduce wasted effort (06:32–07:26). The result?
Payment delays of 90–120 days (04:07–04:50)
Providers losing 7–8% of revenue to preventable errors (12:20–13:12)
High administrative costs due to inefficiency and wasted touches (22:54–23:45)
Patients frustrated by confusing bills and bad financial experiences (15:02–15:55)
MedEvolve layers advanced analytics and workforce automation on top of any billing system. Unlike other AI solutions built on generic claims data, MedEvolve generates its own unique dataset that measures how effective people are at resolving claims and preventing denials (16:47–17:56).
Our solution enables providers to:
Identify preventable revenue leaks (authorization errors, coding mistakes, coordination issues) before they become losses (12:20–13:12)
Track staff effectiveness in real time with benchmarks like first-touch resolution and wasted touches (22:11–23:45)
Automate intelligently without removing human oversight — because healthcare RCM will always require skilled people (14:23–15:02)
Improve margins by reducing unnecessary labor costs and increasing clean claim rates (22:11–23:45)
Rural hospitals, specialty practices, and outsourced BPO billing companies are all under pressure (09:34–11:17). With margins shrinking and insurers leveraging AI to deny more claims, providers need tools that go beyond reports and actually drive measurable outcomes (07:26–08:28).
With Effective Intelligence®, MedEvolve clients are seeing:
Clean claim rates up to 85% without human intervention, compared to 40–55% industry average (22:54–23:45)
First-touch resolution above 90%, compared to an industry average of ~60% (22:54–23:45)
Significant cost savings from eliminating wasted administrative effort (23:45–24:37)
The healthcare revenue cycle is broken, but it doesn’t have to stay that way. MedEvolve is helping providers plug revenue leaks, stay independent, and remain financially strong, even in one of the toughest business environments in decades (08:28–09:25).
Learn how Discovery Behavioral Health’s approach using Effective Intelligence® has realized a 5.2% improvement in cash flow, created 30% more capacity in its revenue cycle team and benefitted from a 13% improvement in zero-touch rates, a key performance indicator that illustrates the percentage of claims that get paid without any human intervention.
Don’t make high-stakes decisions for your healthcare organization with incomplete or misleading data. Traditional metrics barely scratch the surface. Using Effective Intelligence®, you can generate and track new revenue cycle benchmarks that focus on understanding where in the process avoidable touches are happening and effectiveness of staff.
Effective Intelligence combines Patient Financial Clearance Automation, Medical Billing Workflow Automation, and Real-Time RCM Analytics in a cloud-based platform designed to integration with your current EMR/PM technology to measure the effectiveness of your RCM staff.
Review and assess your practice’s financial status in 5 min or less and know exact where you are losing money and why. Measure the work effort of every revenue cycle employee, incentivize and retain your top performers, and help employees that need improvement.
You can prevent most common denials, rejections and write-offs during the scheduling and pre-registration process in advance of the appointment. Configure checkpoints and use central task management to quickly clear patients and keep your front office staffing needs at a minimum.
As team members log in to the web-based application and record each “touch” of a claim, outcome, and next task, key data points are recorded like who completed the task and when, outcome, task notes, internal / external messages sent, collection success and other data points that feed into our real-time analytics.
Reduce RCM labor dependence with financial clearance, insurance A/R, & patient A/R automation modules with real-time analytics.
Increase productivity and simplify front & back office processes while keeping your staff focused with our flagship PM system.
In this episode of Disruption/Interruption, Matt shares how generative AI and a focus on human accountability can help providers achieve “zero touch” claims, reduce waste, and improve access to care,
November 11, 2025 — MedEvolve, Inc., a pioneer in AI-powered revenue cycle automation and analytics, today announced its acquisition by Emergence, an enterprise backed by The Pritzker Organization.
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