Healthcare results. Measured, not estimated.
Two production deep dives. Patient collections and HIPAA-compliant intake. Zero slide decks.
$535K collected in 123 days. +129% vs. legacy on the same patient panel.
AI-assisted patient-billing platform covering 100% of patient-responsibility outreach: SMS, email, payment links, payment plans, and outbound AI voice. In continuous production since Dec 15, 2025. All measurement from the practice’s RIS.
I’ve run a multi-location diagnostic imaging center for 15 years. I watched patient balances age out on legacy billing year after year — same ceiling the rest of the industry hits. So I built the fix myself and ran it on my own ledger. Every number below is from the practice’s RIS. A pipeline generates the measurement pack; anyone can audit the math. This isn’t a pilot. It’s in production, on live books, and it’s beating the industry.
By mid-2025, net A/R had grown to $3.43M with 41.1% aged over 90 days and DSO at 46.7 days. Patient-responsibility A/R — thousands of small balances chased by hand — kept widening the gap. Statements plus occasional staff calls couldn’t keep pace. Patient balances are the fastest-growing segment of healthcare A/R and historically the hardest to collect because traditional billing companies leave them on the table.
AI-assisted patient-billing operating system with 12 observable capabilities: approval-gated settlement campaigns, inbound SMS intent classification, autonomous safe-intent replies, dispute manager, risk scoring + worklist prioritization, payment prediction, send-time optimization, payment-plan negotiator, and a semi-autonomous follow-up agent. Built on Retell AI + Twilio + Stripe + Make.com. HIPAA from day one — BAAs with every subprocessor. PCI handled at the Stripe layer (no card data on practice infrastructure). Patient-responsibility only by design; insurance billing remains in the existing RCM stack.
60 days from concept to production. Live since Dec 15, 2025. ~5 months of continuous operation and counting.
December 15, 2025
In the controlled 123-day measurement window (Dec 15, 2025 → Apr 16, 2026): $535,623 gross collected, +129.4% vs. the legacy platform over its equal-length prior window on the same patient panel. 75.8% of patient responsibility collected by 90 days (vs. 53.1% on legacy, and ~15 points above HFMA MAP Keys industry median). Cost-to-collect 1.39% — below HFMA’s 2–3% best-practice benchmark for digital-first platforms. Per-paying-account collection $182.62 vs. $133.87 on legacy. DSO trajectory cut from 46.7 to 26.5 over the same operating period. Underlying monthly gross charges essentially flat at ~$2.19M, proving the improvement is collection speed, not reduced billing. Full methodology in the deep dive.
Patient-responsibility A/R is the hardest segment in any billing operation — thousands of small balances chased one at a time. This platform takes the human out of routine outreach and puts every patient balance on a 24/7 cadence: SMS, email, payment link, voice agent, payment plan, dispute manager. Result: more than doubled collections on a flat top line. The platform owns 100% of patient-responsibility outreach; insurance billing and denial management run in parallel in the existing RCM stack and don’t touch this rail. The platform is still running.
Methodology, source data, per-account economics, ramp momentum, limitations, cited sources.
HIPAA-compliant patient intake, fully automated.
Paper intake, PDF forms, manual data entry, HIPAA exposure.
End-to-end digital intake platform on Firebase + Twilio + AWS SES with Gemini AI summarization. Database-driven pre-fill, SMS and email invitations, kiosk mode for in-office tablet completion, native Spanish/English toggle.
Active in production at imaging center.
Patients arrive with forms pre-completed. Repeat visitors skip redundant fields. Staff data entry eliminated. HIPAA-compliant end to end. Published performance metrics coming Q2 2026.
Intake is the first 15 minutes of every patient experience. Automating it frees staff for work that requires judgment.
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