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5x increase in processing capacity when compared to manual execution

 

Client Background

The client is a national physician organization which uses technology, team-based care, and unique wellness programs to keep patients healthy, prevent disease, and improve care coordination both in and outside of the doctor’s office

Challenges

  • Automate day-to-day operations to create claims, fetch in-patient admissions, care index, and authorization details of multiple health plans or health systems
  • Automate processes dealing with manual edits and load these files for downstream systems to calculate the quality measures, reimbursement rates, and population health

Solutions

  • Implemented 52+ process robots using UiPath for automating routine manual tasks
  • Developed robots to create claims and download files for pre-authorizations, in-patient admissions, discharge information, HEDIS rates, and medical conditions
  • These robots can access multiple healthcare systems and perform all operational tasks like finding specific plan patient care information, member pre-auth files
  • Robots were configured to edit the downloaded files as per clients’ proprietary format and load edited files into client’s system

Tools & Technologies

Ui Path, Microsoft SQL Server

Key benefits

  • Significant time and cost savings while eliminating human errors from routine activities
  • 5x increase in processing capacity when compared to manual execution
  • Robots enable consistent, highly efficient operations that result in higher customer satisfaction
  • Enabled end-users to perform value-added tasks and executed pre-determined workflows to assist them further
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