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COMPREHENSIVE AUTOMATION IN HEALTHCARE

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Drive Positive Healthcare Outcomes with Automation

The healthcare sector is also experiencing one of the most disruptive periods to date. While providers confront hindering factors to improve patient outcomes, increase operating margins, and improve patient experiences, many payers operate on disjointed and fragmented systems and are facing declining profitability. These demands are causing consolidation in the industry, resulting in the need for the large-scale data integration, process automation, and advanced analytics.

225,000

"Hours saved by automation after three years" - Forrester

$1 Trillion

Known improvement opportunities in healthcare - McKinsey

30 - 40%

Lower cost of underwriting and claims processing with automation - Accenture

Getting started with automation in healthcare

RPA has applications specific to the healthcare industry and applications that one can find in any large business. Some of the back-office business functions are the most tried and tested RPA deployments that have fast implementation times and a quick ROI. These functions include automating
the onboarding of new staff, invoice processes, general reporting processes, claims management, and supply chain processes, all of which are
applicable to healthcare. The automation of these processes has an average implementation time of 5.2 weeks and an average ROI of 5.3 months.

For providers and payers alike, the potential to automate means thinking through the processes they do daily that are repetitive and systematic. A
software robot can be programmed to take on a variety of these tasks, accelerating cycle times and freeing them up to provide the best possible care for their customers.

Healthcare payers

More than an insurance payer, you're a healthcare partner.

Payer organizations perform essential health insurance payment processes. But innovators know they can have a larger role in the member and provider healthcare landscape.​ UiPath business automation helps you drive efficiencies in traditional payer processes, while becoming a differentiated healthcare partner for providers and members alike. ​

Simplify & Modernize Claims Processes.

Making claims decisions doesn’t have to be a highly manual process with a high administrative price tag to match. Intelligent business automation empowers you to reduce errors while making adjudication processes hands-free.​

Ask us about these business use cases:

  • Multi-Channel Intake
  • Member & Provider Info Edits
  • Member Eligibility Validation
  • Medical Necessity Validations
  • Review Case Determination
  • Claim Processing Audit
  • Claims Adjudication
  • Claim Payment Adjustments
  • High Dollar Claims Audits
  • Post-Authorization Case Review

Deliver Personalized Care Programs.

As a key healthcare partner, you want to deliver innovative programs that help improve clinical outcomes and ensure at-risk members get treatment on time. With a full view of patient health information, as well as individualized member insights, you can collaborate with providers and engage with members effectively. ​

Ask us about these business use cases:

  • High Risk Member Identification
  • Member Outreach Scheduling
  • Risk Assessment
  • Personalized Care Plan
  • Duplicate Case Identification & Merge
  • Eligibility Management
  • Questionnaire Management
  • Member Clinical History Data Gathering
  • Member Correspondence Letter Generation
  • Scheduling Appointments
  • Monitoring Progress

Effortlessly Manage & Use Provider Data.

When managing healthcare data becomes too time and labor intensive, leveraging that data to improve provider and member experiences is nearly impossible. Business automation for provider data management gives payers a central role in helping providers lower costs and members reach their health goals. 

Ask us about these business use cases:

  • Provider Request Document Checklist

  • Roster Data Formatting & Mapping

  • Update Provider Data

  • Provider Data Correction – NPI, PHIN, PIN

  • Provider Correspondence & Notifications

  • Sanctions Validation

  • Provider Taxonomy Management

  • NPI, Education & Address Validation & Verification

  • Provider Contract Setup

  • Payment Reconciliation

A Perfect Score for Every Interaction.

Your Net Promoter Scores (NPSs) matter. Your call center’s ability to provide accurate information in response to inquiries is crucial to ensuring a positive reputation with providers and members alike. ​

Ask us about these business use cases:

  • Account Inquiries & Benefit Look-Up

  • Claims Status Request

  • Insurance Verification

  • Plan 360 View & Care Coordination

  • Pre-Certification & Authorization Status Check

  • Previous Call History Summary

  • Address Validation & Changes

  • Member Demographics Updates

  • COB Inquiries

  • Claim Billing Inquiry

Healthcare Providers

Patients and paperwork shouldn't compete for care.

Behind every stack of documents on a healthcare provider’s desk and every email in their inbox is a story:​ A patient with a health challenge to solve. ​A provider who will spend their evening charting. ​UiPath enables the provider-patient relationship to shift back to building rapport and giving and receiving care – instead of information transactions and provider homework headaches. ​

Move Patients into Care Swiftly.

A patient’s care journey begins well before they visit a provider. The pre-work of onboarding a patient, i.e., insurance verification, data collection, scheduling, etc., is accelerated by using business automation to ensure people who need care become patients as swiftly as possible.

Ask us about these business use cases:

  • Patient Onboarding

  • Scheduling

  • Insurance Verification & Eligibility

  • Document Intake

  • Referrals Management

  • Point-of-Service Collections

  • Financial Clearance & Planning Initiation

  • Appointment Reminders

  • Outreach

  • Pre-Certification & Prior Authorization Submissions

Personalize Care to Accelerate Healing.​

Aggregating, organizing, and understanding patient data shouldn’t prevent providers from delivering personalized care. Business automation for healthcare allows providers to tailor care plans and put healing back on track.

Ask us about these business use cases:

  • Charge Capture & Coding

  • Documentation

  • Lab & Radiology Reports Triaging

  • Check-In

  • Check-Out

  • Lab Order Entry

  • Dx, X-Ray, & Radiology Order Entry

  • Medication Management

  • Phone Triage & Follow-Up Calls

  • Remote Visits & Monitoring

Realize revenue faster.

Highly manual claims processes, managing patient payment plans, and dealing with time-consuming audits: these are roadblocks that keep providers from realizing revenue in a timely manner. ​

With business automation driving efficiency in revenue cycle management, you’ll have the resources you need to provide effective, innovative care programs and services and attract and retain top medical professionals

Ask us about these business use cases:

  • Prior Authorization ​

  • Insurance Claims – Posting

  • Patient Payment – Posting

  • Coordination of Benefits: Primary, Secondary, & Tertiary

  • Price Transparency & Real-Time Estimates

  • Revenue Integrity – Payment Audits (Under & Over)

  • Provider: Insurance Enrollment

  • Revenue Integrity – Charge Description Master (CDM) Management

  • Revenue Integrity – IME or IMR Audits (CMS & Medicare Advantage)

  • Insurance Claims – Denied & Rejected Follow-Up

Reduce clicks. Increase care quality.​

You know you’re experiencing administrative abrasion when providers spend more time clicking a computer mouse than interacting with patients and staff can’t scale to tackle the tasks that keep healthcare organizations running smoothly and safely. ​

Ask us about these business use cases:

  • Clinic Staffing & Scheduling

  • Regulatory & Compliance Reporting

  • P&L Reporting

  • Charge Capture, Documentation & Coding Audits

  • HEDIS Reporting

  • Indexing & Routing Documentation

  • Care Coordination

  • Patient Communications

  • Population Health Management

  • Disease Tracking & Trending

McKinsey & Company has predicted that up to 36% of healthcare has the potential to be automated with attended robots
Whether it’ patient enrollment, researching claims denials or any other manual business activity, by applying RPA to rules-based, labor intensive and error-prone processes in healthcare, you can accelerate workflows, improve accuracy and free internal staff to focus on true process exceptions
RPA is complementary to existing systems and processes, enabling healthcare organizations to address gaps in existing processes where work is still being done manually.
Get in touch

For more information and details on how you can transform and automate your Healthcare operations, please do not hesitate to get in touch with us.

Ogni is a provider of enterprise solutions for AI and automation technologies. Our solution automates overall customer and employee communication experience. We are a performance partner that eliminates inefficiencies.
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