Revenue Cycle Management Case Study
A fragmented revenue cycle, unified — Digital Blue connected a Social Care Network's referral, billing, and payment platforms into one automated pipeline that processed 100K+ invoices and paid out ~$20M in claims.
From Disconnected Platforms to One Automated Revenue Pipeline
How end-to-end integration unified referral, billing, and payment across a Social Care Network
Learn how a Social Care Network connected its referral and revenue cycle platforms into a single automated flow — processing over 100,000 invoices, reducing payment errors, and giving providers real-time visibility into every claim.
The Client's Challenge: Two Platforms That Couldn't Talk to Each Other
A Social Care Network needed to manage revenue separately from referral and service delivery, which meant integrating two distinct IT platforms. Invoices arrived from the referral platform as 837P and 837I files that had to be transformed before they could be imported into the revenue cycle management platform. With no automated way to catch duplicate invoices or missing submissions, every payment carried the risk of error — and downstream coordination with accounting and payment systems, MCO denial management, resubmissions, and provider portal onboarding all had to be built and maintained by hand.
Our Solution & The Results: One Closed-Loop, Automated Pipeline
Digital Blue led the end-to-end integration. We built a data pipeline to ingest 837P and 837I files and transform them into flat billing files, with automated logic to flag duplicates and missing submissions before they became payment errors. We coordinated implementation and testing across the RCM, NetSuite, and Bill.com integrations, then built a response-file process that returns paid date, amount, and status back to the referral platform — keeping both systems in sync. We also managed provider onboarding to the partner portal, giving providers real-time, claim-level payment visibility. The result is a single automated flow that has processed 100,000+ invoices and paid out roughly $20M in claims, with denial management and resubmission built directly into the workflow.
Key Impact:
100K+ Invoices Processed
~$20M in Claims Paid Out
Closed-Loop Payment Automation
