Situation
A new revenue cycle leader for a large southeastern health system brought R1 in to replace a well-known underpayment recovery vendor. Despite a lengthy relationship with the former vendor, the leader felt there were significant recoveries being left on the table.
Solution
Immediately after deploying R1 Zero Balance across their facilities for hospital (HB) underpayments, R1 began to identify and recover underpayments opportunity. As a partner, R1 worked with the revenue team to review historic data for additional potential exposure behind the previous zero balance vendor. After an assessment, R1 identified considerable revenue opportunity in the client’s transplant service line as well as their CDM maintenance and billing accuracy.
Results
Working together, R1 helped the client identify $8M in the first year after go-live in the zero-balance space and has recovered $1.5M to date. Combined with other services, the overall R1 engagement is driving significant value – approaching $25M in recoveries since 2023.
R1’s collaboration and expertise in the zero balance space is second to none. The vast coverage of their underpayment rules library combined with their deep subject matter expertise across all payers has helped us unlock missing revenue that other partners were missing. I know R1 will deliver undetected value and partner closely with me to fill gaps in the revenue cycle.
More in Underpayment Recovery, Zero Balance
Revenue Performance Solutions Transform Reimbursement
R1 Awarded ‘Best in KLAS’ Across Multiple RCM Categories for 2026
Choose the Right BlueCard® Plan Every Time
