RPA Case

Healthcare

Healthcare organizations continue to operate under high regulatory demands, complex administration, and with excessive amounts of patient data. Robotiproc’s robotic process automation (RPA) solutions improve staff, service, and compliance with their repetitive nature.

1. Claims Processing

🔴 Problem: Manual handling of insurance claims means delayed payments to the facility and increased administration burden.

🔷 RPA Solution: Bots extract claim data, validates the data against policy rule sets, and processes the claim to the appropriate payer system.

📈 Impact: Quicker turnaround for claims, reimbursement accuracy improvement, and timesaving for processing claims.

2. Patient Appointment Scheduling

🔴 Problem: Call centers are inundated with manual appointment scheduling and rescheduling.

🔷 RPA Solution: Bots check physician availability, send confirmation and reminder notifications, and schedule appointments according to patient preferences.

📈 Impact: Decrease in no-show attendance rate, increase in patient satisfaction, and increase in manual administrative time.

3. Data Entry to/from EHR Systems

🔴 Problem: Nurses and administration are prone to repetitive data entry back into Electronic Health Record (EHR) Electronic Health Record documentation.

🔷 RPA Solution: Bots transfer structured patient information back and forth to intake forms, EHR, and billing.

📈 Impact: Time savings associated with data entry/copy-and-Paste activity exists, decreased errors and improved accuracy in clinical documentation.

4. Eligibility Verification

🔴 Problem: There is a gap between verifying insurance coverage and getting patients scheduled, which causes delays with objectives.

🔷 RPA Solution: Bots automated logging into payers portal, collects the eligibility status and updates the patient record.

📈 Impact: Increased front office efficiencies and proper billing, and authorization.

5. Regulatory Reporting

🔴 Problem: Most reports for HIPAA, CMS from providers of the own services require collecting data from multiple systems and making these reports compliant.

🔷 RPA Solution: Bots automating the collection of data from the systems, validating it and then present it in a compliant report.

📈 Impact: Improved accurate audit readiness while removing the administrative effort.