Ember AI Launches Revenue Integrity Index, Revealing 57% Reduction in Preventable Denials
Inaugural report highlights an 8% lift in net collections, 32% fewer preventable coding issues and opportunities to reduce administrative costs
Drawing on performance data from customer deployments, the inaugural Index highlights a 57% reduction in predicted preventable denials, 32% fewer preventable coding issues and an 8% lift in net collection rates. The findings demonstrate how identifying coding, documentation and reimbursement issues earlier in the revenue cycle can help healthcare organizations protect revenue, reduce administrative burden and strengthen the financial foundation of patient care.
For healthcare organizations managing increasingly complex payer requirements, traditional revenue cycle management often means dedicating significant resources to correcting problems after claims have been submitted. Ember AI takes a different approach, analyzing every patient encounter before claim submission to identify documentation gaps, coding inconsistencies, reimbursement risks and payer requirements that could lead to denials or underpayments.
"Delivering quality patient care requires more than clinical excellence. Healthcare organizations also need the financial stability and operational capacity to support it," said
Additional findings from the inaugural Ember Revenue Integrity Index include:
- Revenue protection and recovery: A customer deployment achieved a 41% reduction in preventable denials, while another identified
$1.5 million in revenue opportunities during its initial deployment. In a live deployment, Ember AI achieved a recovery rate exceeding 31% on payer-resolved claims. - Coding accuracy and costs: In addition to reducing preventable coding issues by 32%, validated workflows demonstrated up to an 80% reduction in coding costs per case.
- Operational efficiency: Ember AI helped save more than 600 estimated staff hours in a live deployment, with 90% of cases handled without human escalation.
- Appeals and follow-up: In a validated appeal cohort, 100% of actionable claims that received a payer decision were successfully adjudicated. The platform also identifies claims that have already been paid, correctly adjudicated or are no longer actionable, helping teams avoid unnecessary follow-up.
"One of the biggest challenges in revenue cycle management is having the visibility to understand where revenue opportunities exist and where reimbursement may be falling short," said
The Ember Revenue Integrity Index is designed to track emerging trends in revenue leakage, denial prevention, coding accuracy and reimbursement performance, providing healthcare organizations with insights into opportunities to strengthen their revenue cycle operations. Future editions will build on these findings to examine patterns across medical specialties, payer requirements and reimbursement challenges.
As Healthcare Quality Week brings attention to the people and processes behind high-quality care, the inaugural Index underscores the importance of operational and financial efficiency in supporting healthcare delivery. By helping organizations prevent avoidable revenue loss and reduce manual administrative work, proactive revenue integrity can give healthcare teams greater capacity to focus on patients while building more sustainable operations.
To learn more or request a demo, visit embercopilot.ai.
About Ember AI
Ember AI is the AI-powered revenue integrity platform that helps healthcare organizations collect every dollar they've earned. Built for the unique challenges of specialty healthcare, Ember AI combines AI with proven reimbursement expertise to level the playing field between providers and payers. By analyzing every encounter before the claim goes out the door, Ember AI proactively identifies coding issues, reimbursement risks, payer inconsistencies, and policy and rate opportunities — taking corrective actions that help organizations reduce risk and increase net revenue. Ember AI seamlessly integrates into existing workflows, allowing organizations to move quickly from implementation to measurable results. With cleaner claims, fewer denials, and no more appeal backlogs, Ember AI helps healthcare organizations create a more efficient, scalable revenue cycle, so clinics can focus on patient care.
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SOURCE Ember AI
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