In an eight-week proof of concept, Gabeo partnered with Rebound Orthopedics to prove that touchless end-to-end automation in denial management is not only possible but transformative. The result: a 92% recovery rate, $54,469.53 in financial impact, and a 4:1 ROI.
Rebound Orthopedics offers comprehensive care in orthopedics, sports medicine, and physical therapy. Known for patient-centered care, the practice serves thousands of patients annually across the Pacific Northwest.
Payers are rapidly adopting AI to deny claims faster and more accurately, often leveraging technology to exploit documentation gaps and compliance failures. Frequent and complex policy changes further disadvantage providers, who still rely on manual workflows to recover denied claims.
Without the right technology, providers risk losing recoverable revenue to growing professional write-offs, operational inefficiencies that limit denial resolution rates, and prolonged Days to Payment that strain cash flow.
"Our goal is to match the speed and frequency of payer denials by delivering autonomous resubmissions and appeals 24/7, ensuring every denied claim is acted upon as swiftly as it was rejected."
Fully automated resubmissions and appeals for targeted denial codes, eliminating human intervention from the recovery loop.
Identifies the core issues behind denials by analyzing trends across CARC and RARC codes, then payer behavior at the policy level.
Leverages historical data, AR reports, and professional write-offs to adapt to payer-specific denial patterns over time.
| Metric | Value | Impact |
|---|---|---|
| Claims Processed | 809 | Automated workflows for five targeted denial codes. |
| Allowed Amount | $55,543.67 | Payer-approved claims post-appeal. |
| Paid (Recovered) | $51,100.18 | 92% recovery efficiency, far exceeding the 70% industry benchmark. |
| Professional Write-Offs | $25,628.92 | Revenue unlocked from claims previously written off. |
| Incremental Recovery | $12,209.61 | Additional revenue generated compared to manual processes. |
| Metric | Value | Impact |
|---|---|---|
| Labor Savings | $16,180 | Eliminated manual intervention for 809 claims, freeing staff for higher-value priorities. |
| Cash Flow Improvement | $441.00 | Reduced Days to Payment by 70 days, accelerating cash flow and liquidity. |
| Category | Amount | Description |
|---|---|---|
| Incremental Recovery | $12,209.61 | Generated through superior recovery rates. |
| Write-Off Recovery | $25,628.92 | Recovered from professional write-offs, addressing long-standing inefficiencies. |
| Labor Cost Savings | $16,180 | Operational savings driven by automation. |
| Cash Flow Acceleration | $441.00 | Faster collections and reinvestment potential. |
| Total Savings | $54,469.53 | Combined financial and operational impact during the POC. |
The industry's first autonomous denial recovery, achieving a 92% recovery rate without human intervention.
Continuously learns from payer policy changes and denial patterns to keep recovery workflows current.
Delivered results during the POC with no integration required. Production deployment is a one-time Epic integration.
Designed to handle all denial categories and payers, providing long-term financial and operational improvements.
Rebound Orthopedics has committed to full production deployment, integrating Gabeo with their Epic system to scale touchless denial recovery across all payers and denial categories. The rollout positions Rebound at the forefront of automated revenue cycle management.
Disclaimer: while the platform automated denial resolution during the POC, one manual touchpoint was required to push final actions through the clearinghouse and payers. A one-time integration is required for full production deployment.