White detailed sand stone texture
All Videos

Success Story: How Medicount automates denial prevention to protect revenue + reduce rework

Medicount’s way forward

Shifting to a proactive denial strategy, Kathy Dudley, Director of Operations and Sue Siebenthaler, Assistant Director of Operations at Medicount have helped move their teams from reactive clean-up to prevention at scale. 

A proactive approach to denial prevention 

Denials don’t start at appeal — they start upstream. Rather than addressing denials one by one, taking a holistic approach to denial prevention helps organizations identify risk early and mitigate issues before claims reach adjudication. 

Automation where it matters most 

For organizations operating on thin margins — such as ambulance services with high volume and low-dollar claims — automation must deliver measurable return. 

“Ambulance claims are small dollar claims, and we don’t get the insurance upfront,” said Dudley. “We put a lot of work in the frontend to get that insurance, and we have to be really diligent about every feature we use to ensure the return makes sense. We definitely rely heavily on Auto Eligibility at the time the claim hits Waystar.” 

Using Auto Eligibility Verification and AI-powered prioritization, teams can correct insurance issues quickly and keep claims moving — even as payer rules change. 

“It’s much easier to handle a rejected claim than a denied claim,” Siebenthaler shared. 

Measurable results, delivered fast 

Leveraging Waystar’s software, Medicount has seen measurable outcomes: 

<2% payer rejection rate

97.8% clean claim rate 

8% YOY improvement in first-pass payment rate

$5.7M billable opportunity recovered with Coverage Detection  

Empowering teams through process-driven work 

Automation didn’t replace staff — it elevated them. Teams shifted from task-based work to process ownership, focusing on continuous improvement rather than manual rework. 

“We really have shifted our staff to be more process-driven instead of task-doers,” said Siebenthaler. “So, we focus them on the process, reward them when they come up with a cleaner process, and celebrate their success.” 

Learn how you can get meaningful results with Waystar.

Speak with an expert

Extra Grunge Rusty Pattern Background, vignetted
Newsletter

MONTHLY NEWSLETTER

Get Insight delivered to you every month