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How a 26-Hospital Health System Transformed Its Revenue Cycle Operations with MediStreams

When Sharon Litchfield joined Piedmont Healthcare as Director of Cash Applications and Credit Resolutions, the health system was experiencing rapid growth, and the revenue cycle team continued to face mounting pressure from increasing volume and complexity.

Litchfield stepped into a multi-entity environment where automation was in place but still needed refinement to truly scale. Her focus became optimizing existing processes, enhancing visibility, and ensuring her team could operate efficiently and strategically.

Fast forward to today, Piedmont processes up to $50 million in payments daily – a scale that would have once required a significantly larger team. With MediStreams and Litchfield’s leadership, they’ve achieved it with confidence, control, and without additional headcount.

“Every health system I’ve worked in has had messy money,’ Litchfield said. “And most of that mess comes from manual processes. What impressed me at Piedmont was that MediStreams had already started solving those problems—and we’ve continued building from there.’

The Tipping Point:
Too Much Volume, Too Little Visibility

As Piedmont Healthcare expanded across Georgia, so did the complexity of its revenue cycle. Each new hospital and clinic brought additional lockboxes and bank accounts, more billing vendors, and thousands of incoming payments that had to be matched, reconciled, and posted accurately, every single day.

At the time, Piedmont’s payment processes were deeply manual. Staff were tasked with pulling daily deposits, hunting down matching remittance files, and manually reconciling them line by line before posting to Epic. It was a slow, error-prone, and resource-intensive process.

Based on Litchfield’s years of experience, the manual verification process can be particularly timeconsuming. “Organizations are constantly having to spend time verifying what should already be known,’ Litchfield recalled. “If a deposit came in but didn’t have an associated file, it triggered a scramble. People are chasing paper, digging through systems, and spending time trying to solve problems the system should have prevented.’

“With MediStreams, we were able to eliminate the manual chaos, deliver real-time transparency, and scale with the organization’s continued growth,’ she said.

The MediStreams Difference:
Automation with Confidence

Piedmont engaged MediStreams to automate reconciliation, remittance conversion, and payment posting—all while ensuring clean, accurate files entered into Epic.

Today, MediStreams matches, reconciles, splits, and delivers payment data directly into Epic—often within hours. If a file is clean, Litchfield’s team doesn’t even touch it.

But the impact goes beyond efficiency. It has created enterprise-wide visibility into remittances. “The transparency gives everyone the assurance that we have what we need to post. If our follow-up team has any questions about what really came in on the remittance, they can easily access a hard copy of it in the system and then post the remittance with greater confidence.’

Results That Scale with Growth

Piedmont now processes between $25 and $50 million in payments daily, typically across 42,000+ checks. Despite that volume, Litchfield’s team hasn’t had to grow at the same pace. Instead, the manual posting workload has been reduced significantly, and the team has been able to refocus on higher value efforts.

Even weekend and holiday postings run smoothly. Litchfield recounts, “I came in one Saturday and saw $3 million had posted. No one was working. That’s peace of mind.’

Collaboration that Goes Beyond the Contract

Litchfield not only uses the MediStreams solutions, she also helps shape them. As a member of the MediStreams Client Advisory Board, she contributes ideas that inform the company’s strategic roadmap and product evolution.

“MediStreams doesn’t just listen—they collaborate,’ she said. “I can bring them a challenge or an idea, and they truly think with me to explore solutions.’

This collaboration proved essential during the Change Healthcare outage in 2024, when paper remits surged. MediStreams helped Piedmont slash conversion turnaround times from seven days to one or two, keeping the revenue flowing and the pressure down.

“They didn’t just keep up,’ Litchfield said. “They really ramped up, which helped minimize the damage for us during this challenging time.’

In addition to Advisory Board meetings, MediStreams is constantly working hand-in-hand with each customer to identify new opportunities for further automation. The teams look at payer trends to find matching criteria or check numbers that enhance the auto-reconciliation rates.

Positioned for the Future:
Smarter Correspondence with AI

MediStreams’ latest advancement, its AI-powered payment reconciliation and correspondence platform, is already shaping Piedmont’s future roadmap. Designed to reduce administrative burden, this solution uses artificial intelligence to extract key data points from correspondence, prioritizes items based on urgency and financial impact, and accelerates document routing and resolution.

For Litchfield, that means faster insight, fewer missed opportunities, and more value from her team’s time.

“AI that can intelligently organize and prioritize correspondence – that’s exactly what we need,’ she said. “It’s not just about automating what we do today.

It’s about doing things we never thought possible.’

The Bottom Line

What began as a mission to eliminate manual reconciliation has become a broader transformation of Piedmont’s financial operations. MediStreams now helps the health system handle growing volumes with speed, accuracy, and reliability—even during holidays, weekends, and nationwide disruptions.

Want to learn how MediStreams can help your team post faster, work smarter, and calm the chaos of healthcare payments?

Explore what MediStreams solutions can do for you at www.medistreams.com.

About MediStreams

MediStreams provides healthcare payment and remittance automation solutions that streamline complex payment processes. With industry-leading accuracy, real-time visibility, and rapid configurability, the MediStreams Cascade™ product suite turns manual processes into automated workflows that empower organizations to post and reconcile payments faster, more efficiently, and in a scalable, cost-effective way. Follow us on LinkedIn or learn more at www.MediStreams.com.

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