Illustrative scenario. Figures are modelled on typical Omnifys deployments and are not drawn from a named client engagement.
The challenge
A specialty practice submitting 4,000 claims a month saw roughly 18% of claims denied on first pass. Denials were worked reactively, resubmissions took weeks, and the practice was writing off recoverable revenue simply because nobody had capacity to chase it.
What Omnifys deployed
- Pre-submission claim scrubbing against payer-specific rules
- Denial pattern detection to fix root causes, not just individual claims
- Automated resubmission workflows with documentation attached
- Days-in-AR reporting by payer and service line
Agents used: Insurance Claims Processing Agent, Revenue Cycle Management Agent, Medical Coding Agent (ICD-10/CPT).
Results
- 47% — reduction in first-pass denials
- 21 days — cut from average days in AR
- $312K — annualised recovered revenue
- 3 — payer-specific rule gaps identified and fixed
Why it worked
Most denials were predictable and repeated. Once the pattern detection surfaced them, three fixes eliminated the majority of the problem permanently.
Explore this for your business
Every Omnifys agent routes tasks across 15+ leading LLMs, integrates through n8n, Zapier and 300+ connectors, and ships with monitoring, audit trails and human-approval steps you control. Typical deployment runs two to six weeks from discovery to production. Book a free 30-minute consultation to map the highest-impact automation for your team.