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SimiTree Saves 6,000 Staff Hours a Year on Claim Status Updates

SimiTree’s billing team was manually checking the status of 10,000 claims each month. With a Claim Status AI Agent, the firm reduced processing time from 5 minutes to 2 minutes per transaction, achieved 99.32% accuracy, and generated estimated annual cost savings of $240,000.

claim denial
EHR
INFO REQ
Market
INFO REQ
Go-live
INFO REQ
The impact

Faster claim status updates across 10,000 monthly transactions

6,000 hours
Staff time saved annually.
$240,000
Cost savings delivered per year.
99.32%

Accuracy achieved across claim status updates.

2 minutes

Processing time reduced per transaction.

Client summary
SimiTree is a tech-enabled healthcare consulting and services firm specializing in post-acute care, home health, hospice, and behavioral health. The firm provides billing, coding, data analytics, consulting, and recruiting services and reports serving more than 16,000 agencies, completing 2,500+ executive placements, and maintaining a 90% client retention rate.
Its billing team was handling 10,000 claim status transactions each month. The manual workflow required 5 minutes per transaction and consumed 833 staff hours monthly.
The opportunity

Manual status checks were consuming 833 staff hours every month

TRANSACTION VOLUME

The billing team processed 10,000 claims each month and had to check their status across thousands of insurance payers.

STAFF CAPACITY
Repetitive status lookups kept staff from resolving complex denials and addressing high-priority claims. A growing client base increased the need for a faster, scalable process.
FOLLOW-UP DELAYS
The manual workflow delayed payer follow-up and increased the risk of missed or delayed responses and reimbursements.
The approach
Droidal developed a Claim Status AI Agent to manage status checks from claim-data retrieval through billing-system updates and daily reporting. Claims requiring attention remain visible to the billing team for follow-up.
PHASE 1

Collect Claim Data

The AI Agent retrieves claim identifiers and related information from the EHR or billing system to begin real-time status checks.
PHASE 2

Retrieve Payer Responses

It connects to payer portals or clearinghouses, obtains the latest status, and interprets payer-specific response codes.
PHASE 3

Flag Exceptions

Claims that are delayed, denied, or missing a status update are flagged and routed to the billing team for follow-up.
PHASE 4

Update and Report

The AI Agent writes current statuses, response codes, dates, and remarks to the billing system, then emails a daily report of successful updates and flagged exceptions.
Agents deployed

Our Claim Status AI Agent manages routine status checks and surfaces exceptions

Claim Data Extraction

86%

86%
Collects claim identifiers and related data from the EHR or billing system.

Payer System Integration

79%

79%
Connects to payer portals or clearinghouses, retrieves current claim statuses, and interprets payer-specific response codes.

Exception Flagging

64%

64%
Identifies delayed, denied, or unupdated claims and routes them to the billing team for follow-up.

Status Update Entry

92%

92%
Updates claim records with the latest status, response codes, dates, and remarks.

Daily Summary Reporting

78%

78%
Emails the finance or billing team a daily summary of successful updates and flagged exceptions for review and action.

By the end of 2026, Lima Memorial is targeting

85%
of eligibility and benefits checks touchless
32
days in A/R across hospital and medical group
$4.2M
annualised net revenue recovered and retained

What could your team hand over in five weeks?

We’ll map your intake and follow-up workflows against the ones Droidal agents already run and show you the hours on the table.
Book a demo