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Use case · Healthcare back office

Denials, coding, prior auth. Which line moved?

AI now drafts appeals and pre-checks authorisations. The CFO wants that in the operating statement, not in a slide.

What this is

These figures describe an expected pattern for a revenue-cycle operation of this shape, not a named customer’s claim. The number that reaches your operating statement should be your own.

The situation

Revenue cycle is a volume business. Denials get appealed, codes get checked, authorisations get chased. Every one of those is a person and a clock.

The team added AI drafting to appeals and a pre-check on authorisations. Turnaround improved. Denial overturns went up. The improvement is real and completely unmeasured, because it lives across the practice management system, the clearinghouse, and a spreadsheet.

The CFO is not asking for a transformation story. She is asking which line of the operating statement moved, and by how much.

What runs where

  • API gateway

    The appeal-drafting and authorisation services route through your gateway, so cost lands per workflow.

  • Vendor account

    Coder and specialist seats, including browser work.

  • Managed fleet

    One deployed file across the back-office estate. No seat runs unrecorded.

What Oabo shows in the first 30 days

  • Cost per workflow — appeals, coding, authorisation — split out of the platform bill.
  • Overturned denials tied to the drafting work that produced the appeal.
  • Coder and specialist hours absorbed, in the capacity register on their own.
  • A cash figure only where the ledger moved: outsourced coding invoices that fell, write-offs that did not happen.

What to expect

Cash saved
$355,000
Per year. Outsourced coding spend and avoided write-offs, matched to your ledger and net of signed hold-backs.
Capacity created
12,600 hrs
Per year across appeals and authorisations. Reported as hours, never as dollars.

Two units, two blocks. Cash is money your ledger moved. Capacity is time your people got back. Oabo never adds them together.

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