Case Study

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Advancing healthcare access through AI-powered clinical alignment

Ensemble Health Partners is a leading provider of end-to-end Revenue Cycle Management (RCM) services managing everything from insurance authorization and coding to billing and appeals. Acting as a hospital’s full RCM department, Ensemble’s outcomes-oriented model is designed to help providers get paid appropriately for the care they deliver and provide higher quality service to their patients. In recent years, Ensemble has accelerated investment in GenAI and agentic AI to transform how RCM is done, targeting high-friction areas like pre-authorization, medical coding, reimbursement, and clinical appeals. 

These efforts are transforming Ensemble’s cost base and operating model. For example, in appeals—often the most complex part of the process—GenAI has reduced drafting time by 40% and improved overturn rates by 5%, helping hospitals be reimbursed more accurately and efficiently. Across the board, automation is contributing to enabling better, more timely care for patients while improving the speed and accuracy of revenue collection and strengthening the fiscal health of hospitals.

*as of Q3 2025