How a 100-provider FQHC eliminated seven-figure coordination costs and automated tens of thousands of monthly referrals
Aunt Martha's Health & Wellness deployed Linear Health to replace 30 FTEs of manual MCO file processing, automate referral coordination end-to-end, and achieve 3:1 ROI within 90 days.
Aunt Martha's Health & Wellness
FQHC
~100 providers, 20 clinics
Chicago metropolitan area
Referral coordination at breaking point
Aunt Martha's is one of the largest FQHCs in the Chicago region, serving a diverse, predominantly Medicaid patient population across 20 clinics. With over 100 providers generating tens of thousands of referrals every month, the organization faced a coordination crisis consuming resources at an unsustainable rate.
30 full-time employees were dedicated to a single operational function: processing Managed Care Organization (MCO) files. This team alone represented a seven-figure annual payroll commitment.
Care gaps went unaddressed for weeks
Staff couldn't process MCO files fast enough to identify and act on them before the next reporting cycle.
Billing discrepancies caused false flags
Coordinators wasted time chasing care gaps that didn't actually exist.
Referral leakage was significant
Patients referred to specialty care or flagged for preventive screenings were falling through the cracks.
Payer quality metrics were at risk
The ability to close care gaps on time directly impacted reimbursement rates and contract renewals.
Staff burnout was accelerating
Coordinators spent their days on repetitive data entry rather than complex care coordination.
Comprehensive automation platform
Integrated directly with athenahealth, replacing manual workflows end to end.
MCO File Ingestion & Care Gap Identification
Linear Health's AI ingests multiple MCO payer files in bulk, automatically cross-referencing care gap data against patient records in athenahealth. The system validates each gap, identifies billing discrepancies causing false flags, and surfaces only actionable care gaps. What previously took 30 staff members weeks to process now happens automatically.
Referral Coordination, End to End
Incoming referrals from fax, EHR messages, web forms, and payer portals are captured automatically. Linear's AI extracts patient demographics, insurance information, referring provider details, and clinical reasons. The system verifies eligibility in real-time, creates or matches patient charts in athenahealth, attaches referral documents, and posts insurance -- all without manual intervention.
Automated Patient Outreach & Scheduling
Patients are contacted within minutes of referral receipt via SMS, email, and voice AI, with multi-language support critical for Aunt Martha's diverse patient population. Patients can self-schedule or be booked by AI based on provider availability, location, and insurance.
Payer Portal Integration
Linear Health operates across athenahealth and multiple payer portals simultaneously, eliminating the need for staff to log into separate systems to track referral status, authorization approvals, or care gap closures.
Measurable impact
Operational transformation within 90 days of deployment
| Metric | Before | After |
|---|---|---|
| Staff processing MCO files | 30 FTEs | 2 FTEs |
| Annual coordination cost | Seven-figure payroll | Fraction of previous cost |
| Monthly referrals processed | Tens of thousands (manual) | Tens of thousands (automated) |
| Time to patient contact | Days to weeks | Minutes |
| Care gap identification | Manual, batch monthly | Automated, continuous |
| False flag resolution | Manual investigation | Automated detection |
| Referral completion rate | Inconsistent tracking | 95% |
| No-show rate reduction | Baseline | 40% reduction |
| Coordinator workload | 100% manual | 60-80% reduction |
| EHR integration | Manual data entry | Bi-directional sync |
What the customer says
"Linear Health automated our referral operations end to end. We process tens of thousands of referrals every month across Athena and multiple payer portals without manual work. Patients choose their specialists, appointments get confirmed, consult notes come back, and nothing falls through the cracks."
Audrey Pennington
COO, Aunt Martha's Health & Wellness
"Our coordinators used to spend their entire day processing MCO files and chasing care gaps manually. Now the system handles it automatically and they can focus on the patients who actually need human attention. It's completely changed how our team operates day to day."
Veronica Garcia
Director of Operations, Aunt Martha's Health & Wellness
Linear Health Platform
Integrated with athenahealth