Introduction
Nalashaa, a top provider in Robotic Process Automation (RPA), partnered with leading players in U.S. healthcare to revamp the eligibility check process. These clients are experts in medical billing and revenue cycle solutions, dedicated to improving practice performance.
Business Challenge
The eligibility check process involves reviewing patient data in provider portals to extract key details like status, dates, and financials. Despite its apparent simplicity, this process is time-consuming and error-prone, especially when dealing with multiple portals. Manual data entry adds complexity and increases the risk of mistakes, highlighting the urgent need for automation.
Solution
Nalashaa's team embarked on a transformative journey to address the challenges faced by our clients in the eligibility check process. Leveraging our expertise in Robotic Process Automation (RPA), we developed a comprehensive solution to streamline and optimize the entire process.
Authentication
The first step involved authenticating the VIP Eligibility check RDP and Sage Intergy applications. This ensured seamless access to the necessary portals using the provided user credentials.
Report Generation
The first step involved authenticating the VIP Eligibility check RDP and Sage Intergy applications. This ensured seamless access to the necessary portals.
Data Conversion and Insertion
Once the reports were generated, our solution seamlessly converted them into Excel format, facilitating easier data manipulation and analysis.
Eligibility Check Report
The first step involved authenticating the VIP Eligibility check RDP and Sage Intergy applications. This ensured seamless access to the necessary portals.
Value Retrieval
Our solution meticulously retrieved key values such as patient names, statuses, effective dates, and financial details from the Sage Intergy and Availity Web Portals.
Email Notifications
Finally, upon completion of the eligibility check process, our solution automatically sent status emails to designated recipients.
Additional Details:
Development
The code was developed for each of the 10 Carrier portals individually, with thorough testing conducted to ensure accuracy and reliability.
Integration and Testing
The BOT was integrated with all Carrier portals, and extensive testing was carried out to address any potential issues.
User Acceptance Testing
The solution underwent rigorous User Acceptance Testing to validate its functionality and effectiveness in real-world scenarios.
Operational Pointers
With 20 FTEs supporting the activity, the BOT achieves a remarkable 95% FTE saving, processing 1800 transactions per day.
Benefits
Elimination of Repetitive Tasks
By automating the eligibility check process, our solution frees up resources from mundane data entry tasks, allowing them to focus on more strategic initiatives.
Increased Productivity
RPA enables round-the-clock data entry without errors, resulting in significantly higher productivity compared to manual efforts. This translates to the equivalent work of 4 to 8 regular employees, leading to enhanced operational efficiency.
Reduced Errors
By automating the eligibility check process, our solution frees up resources from mundane data entry tasks, allowing them to focus on more strategic initiatives.
Faster Delivery
The BOT completes tasks at a much faster pace than humans, ensuring quicker delivery of results and enhancing overall process efficiency.
Cost Savings
Deploying the BOT significantly reduces operational costs by replacing the work of 4-8 employees, leading to substantial cost savings for the organization.
Technology Stack
Insurance web portals
Remote Desktop Connection
Insurance web portals
Front office web portal
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