Case study: How Providence Anesthesia is positioning for growth with Amperos's agentic workforce

Revenue cycle management is hard everywhere. For anesthesia services it runs on hard mode, and most of what can go wrong does: time-based billing where a single minute changes the units, concurrency rules that shift reimbursement depending on how cases overlap, and credentialing a provider at every new facility. Anesthesia sits among the top three specialties for denials, with rates running 15 to 20 percent.

Billing gets harder still because anesthesia provider services are billed separately from the facility for a single case. Getting the right documentation on time can be tricky when the anesthesia group does not own the facility.

That difficulty costs more than time. Money sitting in unresolved claims is money a group can't put toward hiring providers or serving new facilities. Anesthesia is a hard place to collect under any conditions, and harder still when a group is trying to grow.

Providence Anesthesia has been positioning itself for growth, all while moving onto a new PM system and dealing with the day-to-day of anesthesia billing. Here's how they partnered with Amperos to position the company for the next phase of growth.

The challenge

Providence Anesthesiology Associates (known as Providence Anesthesia) is a physician-owned anesthesia group serving hospitals, surgical facilities, and mobile sites. As the group was looking to grow, claim resolution efficiency needed to improve, while the revenue cycle team was already juggling two other jobs.

The first was a platform migration. Providence was implementing the Imagine PM system to move onto a modern system of record. That meant running two systems at once for a stretch and duplicating work across both. The team had to keep up with ongoing AR while learning a new platform, without adding staff, and while still working old claims in the old system. The transition created a temporary need for additional claim-handling capacity.

The second was PAA's existing external offshore support model, which carried its own overhead. Training, supervision, and quality review all landed on the same small group carrying the migration, and turnover on the team compounded the load. Every hour spent managing the partner was an hour not spent on claims.

Anesthesia resists standard workflows. Claims carry substantial complexity. Billing holds, multiple provider billing structures, and payor-specific reimbursement requirements mean both traditional BPO outsourcing and RPA automation have their limits. Good AR management in anesthesia means pointing experienced staff at the claims that need analytical review, not routine processing.

Providence wanted a partner capable of working first pass denials and follow-up on assigned claims, carrying those claims through to resolution and escalating only the exceptions that genuinely require expertise or organizational judgment.

The solution

Providence was not a new Amperos customer. The relationship started years earlier with AR and denial follow-up, run through Amanda, Amperos's multimodal agent. Amanda called payors and worked payor portals to find out why a claim remained unpaid. That meant the team could do more with less, triage claims, and ensure that the right people with the right experience were working the right claim.

When Providence looked at its next phase of growth, expanding Amperos to work claims end to end followed the same logic. The group wanted to grow its footprint without growing the RCM team at the same rate. That meant changing how claims got worked rather than adding people to work them.

Amperos now takes the first pass on all assigned work, including first-touch denials as they arrive. It works claims across every channel: calling payors, navigating payor portals, pulling EOBs, filing appeals, and resubmitting corrected claims. Every action writes back into Imagine. Escalations and exceptions route to Providence's team, which keeps cost to collect low on routine volume and puts the most experienced billers on the claims that need their judgment.

As part of the PM system migration, Providence identified claim inventory that had aged and required focused review and recovery. Providence assigned that inventory to Amperos, and Amperos has worked through thousands of those claims so the group gets paid for care it has already delivered.

The results

– Ashley Weidner, AVP, Revenue Cycle Management Operations, Providence Anesthesiology Associates

To date, Providence has seen real value through its partnership with Amperos:

• $12.8M of outstanding AR worked. These claims included ongoing denials needing follow-up as well as aged claims requiring review and recovery. More than half were over 180 days old, the point at which most teams stop chasing and write-offs become a risk.
• 69% lower cost per claim worked. The same volume of claims through an internal biller would have cost roughly three times as much. Providence lowered what it costs to work a claim without giving up scope on the claim.
• 50% more volume within two months of going live. Providence increased the share of its AR assigned to Amperos after seeing the first end-to-end results.

As Providence takes on more facilities, it has a scalable way to expand its AR and denial operations alongside its clinical footprint.

What other specialty groups can learn from Providence

Most RCM leaders hear automation and hear fewer people. Providence is running the opposite play. The group is growing, but it has to do so profitably, and without adding headcount at the same pace.

Any specialty with complex coding and difficult payors has work that needs judgment and work that doesn't. If a team spends most of its day on the second kind, its expertise is going to the wrong place. Amperos absorbs the routine volume. The internal team handles the exceptions. And the team grows to be exception managers.

Routine claim work shouldn't be the ceiling on what your best people can do. It doesn't have to be.

Don't let RCM capacity be a ceiling on growth. Learn how Amperos can help you recover outstanding claims, at less than half the cost, and three times faster. Book a demo today.