Charge Capture – Centralized Charge Reconciliation & Revenue Integrity

Forecasted Operational & Strategic Outcomes

About the Customer

One of the largest member-owned health insurers in North America. They serve 30 million members across a vast national network that includes hundreds of thousands of providers and more than 10,000 hospitals.

Managing 189,000 monthly transactions across 300 decentralized facilities through manual, daily processes created a systemic crisis where our clinical leaders were often performing as data entry clerks.
This administrative fragmentation resulted in a “black hole” of visibility, where regional variations in documentation led to revenue leakage and an unsustainable operational burden.

•  Compounded Revenue Leakage: With no centralized oversight, “micro-losses” across 189,000 transactions scaled into millions in lost net patient revenue.
•  Clinical Burnout and Moral Injury: Forcing high-value medical staff to perform manual daily reconciliations diverted time from patient care, directly contributing to staff turnover.
•  Extreme Denial Rates: Manual data entry across 300 disparate sites inevitably led to high error rates in coding and modifiers, triggering a tidal wave of payer denials and costly administrative
  rework.
• Regulatory and Audit Vulnerability: A decentralized, manual process lacked a standardized audit trail, leaving our entire system exposed to significant compliance risks and potential federal
  recoupment.

Lateetud implemented a centralized Charge Reconciliation Platform built on SharePoint and Microsoft 365 that automated the intake, review, and tracking of billing charges across all 300 facilities. By replacing fragmented, manual logs with a single, unified environment, the system ensured timely access to complete charge data through automated daily ingestion, eliminating the delays that previously crippled our revenue cycle.

This centralized experience provided real-time visibility into charge status, allowing clinical and billing teams to prioritize high-value work and eliminate backlogs. The streamlined process fortified our financial controls by enabling instant issue identification and providing a robust audit trail for every transaction. Furthermore, executive dashboards delivered the actionable insights needed to hold departments accountable and proactively close revenue gaps.

Drastic Reduction in Revenue Leakage: All monthly transactions were captured within the 24-hour window.

Enhanced Audit Readiness: Permanent audit trail across all 300 sites.

System-Wide Accountability: Real-time executive dashboards, empowering leadership to identify and remediate regional performance gaps before they impacted the P&L.

The shift from a manual, chaotic process to a centralized, automated platform has had a profound impact on our health system.