January 23, 2026
On the Salt River Pima-Maricopa Indian Community lands in Arizona, River People Health Center stands against the backdrop of four mountain peaks. The orientation is intentional so patients and families can look to those peaks for comfort and healing.
Inside, care goes beyond medicine. The health center blends traditional healing practices with Western approaches, honoring the physical, mental, emotional, and spiritual health of Native people.
Once operated out of a double-wide trailer, the new facility spans 200,000 square feet across three stories and serves about 10,000 community members. Wellness paths wind through the grounds, a demo kitchen and food garden promote healthy living, and a terrain park invites movement—all part of a vision to restore quality of life.
River People Health Center is part of the Salt River Pima-Maricopa Indian Community Department of Health and Human Services (Salt River). Beyond the health center, Salt River delivers a wide range of health and social services, including behavioral health programs that integrate traditional medicine for substance use recovery. Sustaining this vision takes more than compassionate care; it requires a strong financial foundation.
Resolving payment delays to protect patient care
Financial stability is the backbone of quality health care. Without timely payments, community health organizations can struggle to keep the doors open and staff in place. For Salt River, that challenge was real: 161 days in accounts receivable (AR), which is the time it took to collect payment after services.
Salt River’s billing and coding staff were new to the Epic electronic health record system, and their previous system relied on manual claim reviews instead of Epic’s automation tools to scrub claims and verify accuracy before submission. The result was a high claims volume and persistent billing system configuration issues, compounded by state Medicaid payment errors, creating a cash flow bottleneck that threatened payroll, staffing and essential programs. Each day without resolution meant fewer resources for patient care.
“Reducing days in AR translates to receipt of revenue faster,” said Tina Sayers, director of revenue cycle consulting and support services at OCHIN. “As soon as you have money in the door, you can do more with it.”
In early 2025, Salt River partnered with OCHIN billing services to streamline claims and improve automation. What followed wasn’t just a technical fix; it was a partnership built on trust and persistence that laid the foundation for a transformative strategy.
“Through our partnership with OCHIN billing services, we gained a complete understanding of Epic revenue cycle management workflows that helped lower AR days and drive revenue growth,” said Frances Hernandez, revenue cycle manager at Salt River.
Building trust to transform workflows
OCHIN’s approach was straightforward yet effective, starting with on-site engagement to build trust and understanding.
“I meet members where they are every day,” Sayers said. And she meant it. OCHIN provided side-by-side support, working with Salt River’s billing and coding staff to troubleshoot claim denials and improve automation.
“It’s being able to bridge that communication gap, hear them in their own words, and translate best practices,” she said.
That early focus opened the door for meaningful change, making it possible to implement streamlined workflows and smart automation effectively.
“The time spent together wildly exceeded my expectations,” said Laszlo Pook, chief information officer at Salt River. “We had some billers and coders who were quite vocal about how Epic doesn’t do the job. By the end of the first day, they were saying, ‘Can you make it do this? Can you make it do that too?’ They turned that corner on the first day and were very open to participating in subsequent meetings.”
Additional site visits brought OCHIN and Salt River teams together to map workflows on whiteboards and glass walls. They optimized OCHIN Epic by closing open encounters and streamlining claims processing, clearing the path for payments to move forward. They also implemented automation and best practices that reduced manual tasks and sped up clean claims—claims submitted without errors so they can be processed and paid quickly—using electronic payments and AI-driven tools.
“We’d have these two-and three-day marathons where … it was eight to five nonstop. We slid pizza under the door,” Pook said.
“It was that constant iterative process in meeting with (the Salt River team) … the tool was the human, face-to-face interaction.”
This hands-on support uncovered a major Medicaid payment issue that had stalled thousands of claims. OCHIN worked with Medicaid to escalate the issue.
“We weren’t going to take no for an answer,” Sayers said. “Customer service kept telling us they couldn’t help, but there was too much money at stake, so we continued to escalate and persist until we got the right person.”
Persistence clears backlog and unlocks revenue
That persistence paid off. After weeks of troubleshooting and escalation, the call came: “We fixed it.” In one afternoon, a significant backlog of payments cleared and nearly 4,000 claims were processed, freeing funds for staffing, payroll and valuable patient programs.
Some claims had been stalled for nearly a year due to limited processing capacity. “OCHIN’s two-pronged approach helped clear out the backlog and reclaim a lot of money that was just sitting on the table,” Pook said.
Credentialing issues that were blocking claims were prioritized and resolved, and staff development initiatives—including leadership training and an intern-to-hire pipeline—strengthened internal capacity.
“We ate together, we worked together … it was like a big trust-building exercise,” Sayers said.
“Each site visit correlated with measurable drops in AR because decision-makers, billing staff and analysts worked shoulder to shoulder to unblock issues in real time.”
Now, with the new processes in place and support from their OCHIN billing services partners, Salt River ranks among top performers compared to industry benchmarks.
The partnership also restored confidence. Systems worked, and staff could focus on patients instead of paperwork.
“The biggest thing that OCHIN did was to listen to the biller and coder complaints and carefully rearticulate what they heard, ask for corrections, document that, and then demonstrate how we can change the system,” Pook said. “The key strategy was active listening and validation, followed by demonstrating how to make those changes.”
Financial stability fuels community health and wellness
Improved cash flow has eased pressure on Salt River’s billing team, creating bandwidth for new initiatives like implementing Epic Compass Rose for whole-person care and preparing to go live with OCHIN Epic for acute care to manage inpatient care and streamline clinical workflows.
“Sometimes you get mired in the in the minutiae and the stress that you have high days in AR that you can’t see the forest for the trees,” Pook said.
“(OCHIN has) been helping us identify the opportunities, and then our analysts rebuild that airplane in flight and really automate it to become more efficient in our operations.”
Financial stability means Salt River can focus on growth and reinvest in its mission: restoring quality of life, health and wellness for the community.
“By collecting that cash, we’re able to start planning and preparing ourselves for future expansion into other service lines,” Pook said.
Last year, $10.5 billion in claims were submitted through OCHIN to facilitate timely reimbursement for members in 2025. If your organization is facing delayed payments, aged claims or persistent billing issues, OCHIN billing services can help reduce AR days, accelerate cash flow and unlock resources for growth.
Learn more about OCHIN billing services and connect with our team to explore how OCHIN can help you achieve similar results.
