Stop denials before they start
From patient check-in through credentialing, we stop the gaps that cause denials before a single claim leaves the building.
80+
health systems with >$1B net patient revenue
350+
healthcare clients nationwide
1,000+
hospitals & physician practices served
40+ years
of RCM domain heritage (MedAssist)
Everest Group
Featured IT/BPM Provider 2025 – Operationalizing Generative AI in Healthcare
Everest Group PEAK Matrix®
Major Contender 2026 – Revenue Cycle Management Intelligent Operations
Everest Group PEAK Matrix®
Major Contender 2024 – Revenue Cycle Management Operations
Everest Group PEAK Matrix®
Star Performer 2024 – Revenue Cycle Management Operations
WHY THIS MATTERS
Denial prevention starts at the point of access
Eligibility gaps, authorization failures, and registration errors at the time of care request drive the majority of denial volume—giving providers a critical intervention opportunity earlier in the patient journey.
Front Door Failures
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41%
of U.S. healthcare providers report claim denial rates exceeding 10%.
MGMA Medical Group Management Association, reported by Fierce Healthcare, 2026
Authorization Burden
69%
Prior authorization remains a major health care barrier for 69% of survey respondents, causing delays and frustrations for insured adults.
KFF Health Tracking Poll
Tech Potential
$20B
Human and AI workforce with thoughtful automation can unlock over $20B in savings, and save 70 minutes of administrative burden time.
CAQH Index Key Takeaways, 2024
PROVEN OUTCOMES
Front-door investment delivers end-to-end results
Every stat from live patient access and eligibility engagements contracted performance, not projections
>98%
eligibility verification rate
We help providers achieve real-time eligibility verification with benefits discovery and insurance discovery for previously unidentified coverage that could result in eligibility-related denials at the source.
<48hrs
prior authorization
AI-powered auth determination with clinical document assembly and peer-to-peer coordination reduced auth turnaround timlines from multi-day manual workflows to under 48 hours across health system clients.
500+
Medicaid accounts
Eligibility services with expanded coverage and digital omnichannel outreach secured coverage for 500+ accounts at an acute care hospital, uncovering over $400K in previously inaccessible reimbursement.
~35%
uncompensated care reduction
Digitally-enabled Medicaid eligibility screening, charitable care identification, and coverage discovery programs reduced uncompensated care exposure across health system and hospital clients.
Patient Access Solutions Deep Dive
Orchestrating the patient experience - end-to-end
Our operating model is built around eight interlocking service modules, unified by a shared patient access intelligence layer, covering the full front-end revenue cycle from first contact through credentialing. These solutions are thoughtfully powered by autonomous agents, copilots, automations, with human oversight or in the loop for improved outcomes for healthcare providers.
Scheduling is the entry point to the patient financial journey and the first opportunity to prevent downstream denials.
We help providers capture accurate patient and financial information from the first interaction, creating a clean foundation for every stage of the revenue cycle.
We help providers capture accurate patient and financial information from the first interaction, creating a clean foundation for every stage of the revenue cycle.
- Omnichannel scheduling across specialties and contact channels
- Appointment template and capacity optimization aligned to demand
- Proactive reminders, rescheduling, and waitlist management
- Referral coordination with multilingual support
Missing or incorrect eligibility data is a leading category of preventable revenue loss. Verifying coverage early and flagging gaps before the encounter means claims go out clean the first time.
- Real-time eligibility checks at scheduling and registration
- Benefits detail captured per encounter
- Coverage gap and lapsed-coverage identification pre-service
- Hidden coverage discovery for self-pay patients
Any service rendered without a valid authorization is a claim waiting to be denied. Confirming authorization status well before the service date removes a common failure mode before it reaches the payer.
- Payer-specific determination and submission
- Clinical document assembly and peer-to-peer coordination
- Status tracking through approval or denial
- High-risk procedure flagging and expedited handling
Inaccurate registration is the most direct driver of claim rejections. Digital pre-registration and real-time validation ensure every encounter starts with a verified patient record.
- Digital pre-registration and portal-based intake
- Point-of-service identity and insurance validation
- Duplicate record cleanup and master index hygiene
- Continuous demographic and consent data monitoring
A growing share of every provider's balance is patient-responsible. Proactive front-end counseling converts potential bad debt into secured revenue before the service date.
- No Surprises Act-compliant good faith estimates
- Charity care screening at registration
- Payment arrangements established before service
- Financial assistance and funding navigation
The contact center is the front door to the health system's financial relationship. A fragmented operation creates the errors and missed appointments that quietly drain revenue.
- HIPAA-compliant omnichannel engagement across all channels
- First-call billing inquiry resolution
- Intelligent virtual assistants for routine inquiries
- Speech quality monitoring with multilingual support
A significant portion of known patient responsibility goes uncollected at the point of service. Matching the right approach to each patient recovers revenue before it migrates to bad debt.
- Ability-to-pay segmentation at the front end
- Point-of-service and digital payment capture
- Automated payment plan enrollment
- Proactive outreach on high-balance accounts
Credentialing failures are among the most financially damaging front-end errors. Continuous monitoring and gap alerts protect billable revenue before a claim is ever submitted.
- Initial credentialing through approval
- Commercial and government payer enrollment
- Re-credentialing and expiration tracking
- Enrollment gap alerts and retroactive remediation
WHO WE SERVE
Patient access built for every front-door model
From large health system scheduling centers to single-hospital Medicaid eligibility programs, our patient access solutions deploys at the scale and configuration your patient experience and interactions require.
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Hospitals and health systems
We deliver full front-end RCM with bedside Medicaid eligibility, emergency room financial clearance, and omnichannel scheduling. We prevent denials across high-volume acute care environments.
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CUSTOMER STORY
Eligibility gaps resolved before they become uncompensated care
Securing coverage, accelerating reimbursement, and resolving complex eligibility challenges
A hospital faced staff shortages, billing inefficiencies, and delayed coverage verification. We helped them enhance eligibility support and patient outreach.
500+
accounts covered
$400K+
reimbursed
$1.9M
patient case resolved
7-day
coverage deployed
PROOF OF DELIVERY
Performance evidence from live patient access operations
Three different engagements, three different front-end metrics — all from contracted program data.
20.5%
surge in managed Medicaid enrollment
Omnichannel Medicaid outreach for a large acute care hospital, deploying digital, SMS, email, and phone outreach, reduced uncovered patient numbers by 93%.
>99%
patient registration accuracy rate
Pre-registration combined with real-time data validation and cleanup achieved 99%+ registration accuracy, eliminating registration-driven denials before claim submission and reimbursement.
62%
documents e-signed within 1 hour
Digital document completion and e-sign integrated into the patient access workflow reduced manual paperwork delays and accelerated financial clearance.
INSIGHTS
Latest from the Firstsource team
Insights from the field, real operations, real outcomes, and perspectives from the people making it work in live operations.
READY TO TALK
The denial starts at the first patient touchpoint. So does the fix.
Talk to a patient access specialist today, and get your eligibility, auth, and registration gap mapped.
- A front-end operations expert who manages eligibility and prior auth at health system scale — not a generalist.
- Your current eligibility denial rate and auth delay profile benchmarked against industry performance data, specific to your payer mix and patient population.
- A clear view of the upstream denial prevention and uncompensated care reduction available before you commit to anything.