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Automated Hospice Claim Identification & Medicaid Record Management

Developed bots to reduce person-hours spent on claims processing by 20%.

Challenges

  • The client used a manual workforce to perform day-to-day operations like Medicaid member identification, submitting required medical charts through third-party websites, claims filtering using a practice management tool.
  • Huge amounts of time and resources were spent on mundane and repetitive tasks, which also had higher risks of human errors.

Solutions

  • Implemented 10+ process bots using Ui Path for automating routine manual tasks performed in the client’s practice management system.
  • These bots can access the tool in the client system and perform all operational tasks like finding members for a specific plan, member eligibility check, copy files needed for execution and send automated emails summarizing bots’ execution results.
  • Bots trigger workflows that are carried out by downstream applications as well as monitor the data shared by upstream systems and execute the process on any addition of data to the system.

Tools & Technologies

UI Path RPA, Nextgen Healthcare

Key benefits

  • Reduced person-hours by 20% and captured the operational metrics in the practice management application.
  • Increased task completion rate and achieved high accuracy in sending files through third-party websites.
  • Bots enable consistent, highly efficient operations & customer satisfaction.
  • End-users can now perform value-added tasks and assist them by executing pre-determined workflows.
  • Bots save precious time and resources while eliminating human errors.
Case Study KeyPoints