Madison Memorial Hospital Streamlines Reimbursements and Accelerates Claim Cycles with The SSI Group
July 17th, 2025
CLIENT
Founded in 1951, Madison Memorial Hospital (Madison) is a 69-bed acute care hospital and Trauma Level IV facility located in Rexburg, Idaho. The organization includes a cancer institute (in partnership with the University of Utah Huntsman Cancer Institute), a behavioral Health Unit, Surgery Center, and eight offsite clinics.
Positioned near Yellowstone National Park and Brigham Young University–Idaho, Madison plays a critical role in delivering comprehensive care to its rural and regional community.
CHALLENGE
As a regional healthcare provider in Eastern Idaho, Madison was facing mounting complexities in its revenue cycle operations. As the organization expanded its services across inpatient and outpatient settings – including behavioral health, oncology, and surgery centers – so too did the pressure on reimbursement workflows.
Pain points included:
- Administrative delays in payer enrollment and claims submission
- Manual, time-consuming denial tracking and productivity reporting
- Inefficiencies in claim attachment handling, causing delays and rework
- Disparate workflows that impacted clean claim rates and cash flow
- Limited training resources for onboarding new billers and upskilling current staff
SSI’S SOLUTION
Madison partnered with SSI to implement a tailored, integrated revenue cycle solution focused on visibility, automation, and productivity.
Key capabilities included:
- Enterprise Reporting & Claims Analytics
SSI’s custom dashboards allowed Madison to analyze productivity and denials by payer and remark code – eliminating data silos and enabling better decision-making. - Edits Dashboard & Pre-Claim Intelligence
Real-time visibility into claim edits enabled the team to proactively resolve issues upstream, reducing rework and denial risk. - Electronic Attachments
A streamlined process for submitting documentation with claims helped prevent denials and mailing delays, ensuring quicker reimbursement. - Provider Enrollment Portal
Simplified payer enrollment workflows across multiple clinics with self-service features to track, edit, and manage applications efficiently. - Training & Support Tools
Madison staff benefitted from weekly live trainings, 24/7 webinars, and on-demand resources, enhancing both speed and consistency across the billing team.
People and Process Improvement
Madison used the implementation of new systems as an opportunity to improve and standardize many of their revenue cycle processes. Additionally, new systems provided a perfect opportunity for retraining and establishing new metrics and goals.
Eight new SOPs were created by Director of Revenue Cycle, Brandon Sakota. These ranged from claims submission to denial management resolution processes. Business Office staff at Madison embraced the new opportunity to learn and improve, and push towards new goals in AR days. The team met their end of year AR goals by the end of November. Team morale improved to the best it’s been in recent memory.
RESULTS
Madison has achieved a 33% improvement in days sales outstanding, which was critical to the organization’s success, as represented by the graph below.
Overall improvements in key metrics provided support for the team’s success.
- Clean Claim Rate: Notable improvements driven by edits dashboard insights
- Reduced Reimbursement Delays: Automated attachments and analytics tools shortened processing time
- Faster Enrollment: Streamlined provider application processes cut down onboarding delays
- Improved Efficiency: Reports that once took hours are now generated in clicks, supporting proactive management
“With SSI, everything from payer enrollment to claims attachments just flows better. Our billing teams have the tools, training, and visibility they need – and it’s saving us serious time and effort.”
About The SSI Group, LLC
Since 1988, SSI has been in the business of ensuring healthcare providers are paid timely, efficiently, and accurately. SSI’s product suite provides an enhanced collections process for payers and patients.
For more information about The SSI Group’s suite of claims and billing solutions, request a demo.
Get Started
Make your move toward stronger financial results and smarter care.
