Transforming Revenue Cycle Management with AI: Fox Valley Orthopedics' Success Story

The healthcare sector is a complex and dynamic environment where operational efficiency directly impacts patient care and financial health. For Fox Valley Orthopedics, a premier orthopedic care provider in Illinois, managing these dynamics while serving over 35,000 patients annually was an ongoing challenge. However, by partnering with Adonis, Fox Valley not only overcame key operational hurdles but also transformed its RCM processes into a powerful strategic asset. 

Addressing the Challenge 

Known for innovation and clinical excellence, Fox Valley Orthopedics identified key opportunities to improve its billing and revenue cycle performance. These challenges hindered the organization's ability to optimize reimbursements and maintain strong cash flow, even as it continually elevated its patient care capabilities. 

Limited Visibility in the Revenue Cycle 

Without an integrated view, errors in the early stages — such as eligibility or prior authorization issues — created downstream revenue leaks. These mistakes often went undetected until they became significant problems, delaying claims and siphoning valuable resources. 

Inefficient and Fragmented Reporting 

The manual process of gathering data across various systems resulted in inconsistent metrics and time-consuming reconciliations. Actionable insights required extensive effort, making it difficult to approach revenue challenges proactively. 

Slow Trend Analysis 

Identifying trends in claim denials was another labor-intensive process. Hours of manual review meant delays in resolving recurring issues, leaving less time for staff to focus on improving processes or communicating with patients. 

The Adonis Solution 

Enter Adonis, an AI-driven RCM platform designed to uncover problem areas, reduce denial rates, and improve operational workflows. Through its proactive technologies and data-driven insights, Adonis provided Fox Valley Orthopedics the tools to manage their revenue cycle efficiently and strategically. 

Real-Time Alerts  

Adonis' real-time alert system enabled the team to spot denial trends as they developed. These alerts helped Fox Valley catch issues like prior authorization or coding inconsistencies early, ensuring that claims could be corrected and resubmitted swiftly. 

Prioritized Workflows 

Customizable worklists transformed insights into action by helping staff focus on high-impact tasks. By streamlining workflows, the team could resolve root causes of denials and eliminate redundant, time-consuming tasks. 

Data-Driven Decision-Making 

Through automated analytics and intuitive reports, Adonis enabled Fox Valley to identify patterns across their revenue cycle. This actionable intelligence laid the foundation for targeted training and improved cross-departmental collaboration. 

Results That Speak for Themselves 

The implementation of Adonis brought measurable improvements to Fox Valley Orthopedics, demonstrating the power of AI-driven solutions in healthcare operations. 

Case 1: Avoiding $200K in Denials 

Late in 2023, a surge in CO197 denials at Fox Valley's physical therapy clinics raised alarm. Adonis identified that a regulatory change in United Healthcare's prior authorization criteria for CPT code 97110 had gone unnoticed. Within weeks, the team traced the issue, secured retro-authorizations, and updated billing practices, preventing more than $200,000 in potential revenue losses. 

This swift response reduced denial rates for the affected claims by 84% — dropping from 25% to just 4%. 

Case 2: 60% Denial Reduction in One Week 

A few months later, Adonis once again proved its value when billing code mismatches at Fox Valley’s Ambulatory Surgery Center triggered a new spike in CO197 denials. Adonis’ proactive alerts allowed the team to resolve the issue in record time, reducing the denial rate from 33% to 13% — a remarkable 60% improvement in only one week. 

This underscores the efficiency of proactive insights, as both situations involved the same denial code but were caused by entirely different root issues. 

Long-Term Impact 

Fox Valley's adoption of Adonis has resulted in a sustained 25% reduction in overall denial rates. Within the first four months of 2025, the organization experienced a 5.7x return on investment, as faster resolutions improved cash flow and employee productivity. 

Beyond Metrics: Building a Smarter Future 

The benefits of this transformation don’t only exist in spreadsheets. By reducing manual effort and increasing visibility across the revenue cycle, the partnership with Adonis has allowed Fox Valley Orthopedics to redirect resources toward more valuable activities, such as patient communication and operational improvements. 

Cultivating Team Alignment 

With a unified view of operational performance, teams from intake to billing are now better aligned. This collaboration has enhanced accuracy, reduced processing delays, and even improved the overall patient experience. 

Empowering Staff and Technology 

Adonis' smart automation tools have removed the manual burdens of RCM workflows, empowering staff to focus on decision-making over data gathering. This ability to act faster and with more precision continues to inspire confidence in the organization’s capacity for future innovation. 

The Role of AI in the Future of Healthcare 

Fox Valley Orthopedics' success story highlights an important shift in how healthcare organizations view their revenue cycles. What was once seen as a back-office task is now recognized as a key driver of financial health and operational sustainability. 

By harnessing the power of AI technologies like Adonis, healthcare providers can transition from reactive processes to proactive solutions. The reduction in avoidable denials, the alignment of cross-functional teams, and the acceleration of revenue capture are just the beginning. 

Looking ahead, the role of AI in healthcare will continue to expand, offering providers like Fox Valley Orthopedics the tools they need to remain agile and competitive. These technologies are more than just solutions; they serve as catalysts for broader organizational transformation—enabling teams to focus on what matters most: delivering exceptional patient care. 

See how your RCM processes can be improved with AI.

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