CLIENT ISSUES
Eligibility confirmation with greater accuracy helps streamline claims submission and reimbursements on health plans. It’s also critical data for patients, who increasingly face greater financial responsibility for their care through high insurance deductibles.
Agents were manually logging into healthcare providers portal to check patient eligibility and benefits for upcoming appointments
Update portal notes with necessary information
Agents had to be familiar with more than 120 provider portals, which changes routinely
“Checking eligibility” meant applying more than 250 complex business rules to extract data from more than 35 fields about annual deductible amounts, remaining deductible amounts, etc
When patients made appointments on short notice, agents had to complete these tasks within a day or less. It was a tedious, time-consuming process, prone to errors that could result in patients receiving incorrect information and providers submitting inaccurate claims that would be denied.
AUTOMATION SOLUTION IMPLIMENTED
Expertise in the healthcare industry to design a robotic process automation (RPA) solution that fully automated the service provider’s complete eligibility and benefits confirmation process. Running 24 hours per day, five days a week, 18 software bots automatically execute the following steps:
Extract patient appointment lists from each healthcare provider’s practice portal across all provider locations
Prioritize the appointments for further processing
Extract appointment details by accessing two different applications and 9 different screens
Consolidate the output reports and confirm if patients are eligible for benefits
Validate and update eligibility and benefits details in each practice’s portal.
POTENTIAL BENEFITS AND SAVINGS
lorem ipsum dolor sit amet
The bots process 3,000 transactions per day with 100% accuracy
Savings of 12,000 hours annually in the RCM service process
- Sideio Impetus Pvt. Ltd.
A12 Mathewsons tower, III Level, Mathewsons Trade Centre, Near JLN Stadium Metro Station,
Kaloor, Cochin-602017 - Trivandrum – CKRA 22, Kurumkulam Road, Mannnathala Trivandrun
Connect Us
Quick Links
Visit Us
