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Case study · Healthcare Providers · Collections

Early-out self-pay AI lifts collections 29% at a 900-provider physician group

A national physician group was placing early-out self-pay accounts with agencies at 90 days because in-house outreach couldn't keep pace. pronix.ai deployed an agentic early-out program on voice, SMS and email with propensity-to-pay scoring, self-service payment plans and financial-assistance screening — collections lifted 29% and cost-to-collect dropped 38%.

Client
Multi-specialty physician group, 900 providers across 6 states
Industry
Healthcare Providers
Platform
Amazon Connect · Kore.ai Agent Platform · Athenahealth · Salesforce Health Cloud
By pronix.ai CX Engineering7 min readQ3 2026
+29%
Early-out self-pay collections
-38%
Cost to collect
58%
Balances resolved without human touch
0
TCPA / healthcare audit findings

*Representative outcome; results vary by client, scope and platform configuration.

The challenge

Self-pay balances after insurance had grown to 22% of AR and the in-house early-out team could only touch each account twice before agency placement. Patients wanted digital-first, self-serve options; regulators demanded strict TCPA, healthcare-privacy and state-collection compliance on every contact.

Our approach

Step 01

Propensity-to-pay segmentation

A model scored each account for likelihood to self-resolve, best channel and best offer — high-propensity accounts went digital-first, hardship signals were routed to counselors before any collections contact.

Step 02

Compliant multi-channel cadence

Voice, SMS and email orchestrated with consent, quiet-hours and frequency caps enforced by policy — every touch logged with script version and consent state for audit.

Step 03

Self-service resolution

Patients could view a plain-English statement, split into a payment plan up to 24 months, apply for financial assistance or pay in full — all without agent contact, all inside a healthcare-safe portal.

Step 04

Counselor copilot for exceptions

When patients called in, a counselor copilot surfaced account context, payer status, plan eligibility and prior offers — average handle time on collections calls fell 34%.

We are collecting more, from more patients, with fewer complaints — and we placed 40% fewer accounts with agencies last quarter.

Director of Patient Financial Services
For VP Revenue CycleFor CFOFor Director of PFSFor Compliance Officer

Illustrative case study. Scenarios, metrics, quotes and client details are representative composites based on Pronix engagements and industry benchmarks unless a named client is shown with written consent. Outcomes vary by client, scope, data quality and platform configuration. Nothing on this page is a guarantee, warranty or professional advice. See our Terms of Use for the full disclaimer.

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