Automated the eligibility determination process
- The client had a lot of manual intervention for their claims administration process which they wanted to automate.
- They wanted to automate the eligibility determination process and also needed customization of their HIM system to have reports and integration with the mobile app.
- We implemented 20+ process robots using UI Path for automating manual routine tasks in-patient eligibility and claims management.
- Built robots to extract patient eligibility details from Medicaid.
- Automated fetching latest claim status.
- Created an FHIR server for the electronic transfer of data through secure APIs.
- Created an accreditation mechanism for secure transfer and use of data elements.
- Customized the legacy app for HIMS to add reporting capabilities.
- Developed mobile app for appointment scheduling and tracking of patient information.
Tools & Technologies
- Saved about 90% of the manual effort.
- Robots produce consistent and highly efficient operations, and in turn, enhance customer satisfaction.
- Increased processing of eligibility check and claims administration capacity by 5x when compared to manual execution.
- Reduced customer service center calls by 60%.