Healthcare Solutions

Patient Registration and Encounter Data

THE CHALLENGE

A Healthcare System had full-time employees (FTEs) manually entering patient encounter data into the Cerner Revenue Cycle Accounting system. The manual process encompassed roughly 3,500-4,100+ transactions per month with an average handling time of 2 minutes per transaction. In addition, they experienced a 30% error rate on the records that were input manually.

RPA SOLUTION

CampTek Software with its RPA proven methodology was able to automate the entire process. The timeline from process analysis, development, testing, client acceptance and  then into production was a mere four weeks from start to finish.

VALUE ACHIEVED

  • This one automation ultimately saved an average of 32 hours per week and a total time of 252 hours over a two-month period. This automated process has also significantly improved the accuracy of data entry resulting in a 2% business exception rate.
  • Based on this success, CampTek Software and the customer have added additional High-Value RPA automations to other manual processes in the department.
Eligibility Checking

THE CHALLENGE

Agents of a leading Healthcare System were manually logging into healthcare provider portals to check patients’ eligibility and benefits for upcoming appointments. Accurate confirmation streamlines claim submissions and health plan reimbursements. However, with more than 120 provider portals changing every quarter and agents expected to be familiar with each of them, the verification process was complex.

RPA SOLUTION

CampTek Software implemented an (RPA) solution for the provider’s complete eligibility and benefits verification process. The automation process pulls patient appointment lists from healthcare provider portals across various locations, prioritizes these appointments, extracts appointment details by accessing two different applications and 14 screens, consolidates output reports and confirms patients who are eligible for benefits. The bots also validates and updates eligibility and benefits details in each practice’s portal.

VALUE ACHIEVED

  • 5,000 Transactions processed per day
  • 100% accuracy
  • 17,000 hours saved annually
Insurance Claims Processing

Healthcare and Insurance companies have to process claims that are raised against insured members for any initial process to trigger claims processing in their system and which also forms the paper-based proof that can be saved. Processes like these can be automated such that the forms can be read and then the manual data entry to the applications where these claims are processed, can be done by the RPA solution.

THE CHALLENGE

 A leading healthcare companyies process for handling claims for was slow, error-prone, and complex. Inundated with the information of 70 million people, the workflow typically saw high defect rates, resulting in lower accuracy of registrations being loaded and inefficient handling of sensitive information. Backlogs and high-turnaround time were also major pain points for the company.

RPA SOLUTION

Robots supported the claims value chain and automated 35-40% of the process on the platform. The automation improved compliance with regulatory requirements and enabled risk-free transaction processing for sensitive data.

VALUE ACHIEVED

  • 68% improvement in productivity
  • 45 minutes of manual effort saved
  • More than 95% enhancement in accuracy