When operations run with depth and ownership, the outcomes hold up.
Clean claim rate
Denial rate
Cost-to-collect cut
A US healthcare technology platform that automates eligibility, claims submission, denial management, and payment posting for vision and medical insurance workflows. Data Solutions has served as the offshore operations partner behind the platform's RCM work for over two years.
The platform's value proposition rested on being able to deliver high-quality eligibility verification, claims submission, and follow-through for insurance work that traditional billing services struggled with — high-complexity verifications, claims with elevated denial risk, and follow-up workflows that required real judgment about payer behavior. As the platform scaled, the operations team that supported these workflows became a strategic bottleneck. The platform needed an offshore partner who could handle the operational depth of the work, not just the volume.
We built a dedicated team trained on the platform's vision and medical insurance categories, the payer behaviors and rules within those categories, and the operational nuances that determined whether a claim got paid or denied. The team plugged into the platform's existing workflow and became the back-office layer behind it. Operations covered the full billing cycle — claim scrubbing, submission, denial management, and payment posting — with the most operationally complex work handled by senior operators rather than automation.
A US-based healthcare technology partner whose ecosystem unifies practice management, patient engagement, claims processing, and revenue cycle solutions for a national network of provider practices. The engagement covers high-volume claims clearinghouse operations, ERA-driven payment posting, and back-office RCM services within the partner's revenue cycle offering. Data Solutions has served as the offshore operations partner behind the partner's US operations.
The partner needed an offshore RCM operations capability that could meet the quality and consistency standards of a US-facing operation serving thousands of practices. The volume of claims flowing through the clearinghouse — across hundreds of payer connections — demanded operational scale that previous offshore vendors had failed to deliver consistently. Quality could not slip as volume grew.
We built an operational structure sized for the partner's scale — dedicated teams organized around the partner's payer connections across the practice network, trained on the payer behaviors and workflow variations that shaped quality consistency. In-house automation handled the high-volume claims clearinghouse and ERA-driven posting; human operators worked the exception paths and quality checks. Regular working sessions with the partner's operations leadership tracked what was changing in payer behavior, claim trends, and quality metrics across the network.
Our engagements run for years, not quarters. The metrics above aren't from a single strong period — they're sustained across multi-year relationships, through changing payer behavior and evolving claim volume. In RCM, anyone can have a good month. What's hard is the next thirty.
Our engagements define success upfront — against the client's baselines, not vague 'service level' metrics. Denial rate, AR days, claim acceptance, posting cadence, recovery against aging buckets. Measured proactively. Renegotiated as the engagement evolves.
Our structural approach stays consistent — onboarding, dedicated teams, calibrated cadence, automation where it earns its place. But the application flexes to the engagement: payer mix, PMS configuration, workflow, baselines.
