Hospital Rounding Claim Creation Bot
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Introduction
The Client, a leading urology healthcare facility in the US, sought Nalashaa's assistance to automate the claim creation process for external hospital visits. Automation was needed to identify face sheets and update claim numbers based on weekly reports provided by the client team.
Challenges
Updating approximately 75-80 claims per week was cumbersome and repetitive, particularly with only one staff member handling it. Additionally, the client was paying a high cost to an external contractor for this work.
Nalashaa's team worked closely with the client to understand and replicate the existing process using an RPA (Robotic Process Automation) solution.
Solution
A face sheet is a summary document that provides essential information about a patient’s visit, including identification, encounter details, and claim-related data. The bot's task was to ensure that the correct claim number is recorded on the face sheet based on the information provided in the weekly report. This process is crucial for accurate billing and record-keeping.
The client provided a weekly report detailing all hospital visits. Nalashaa designed the Hospital Rounding Claim Creation (HRCC) bot to:
Read the report and search for patient information to create claims.
Locate the face sheet corresponding to the encounter date.
Update the claim number on the face sheet.
This automation eliminated the need for an external contractor to perform these tasks, reducing associated costs. Additionally, the bot generated a report of its work and sent a summary via email notification.
Benefits
Success rate
The HRCC bot achieved a 100% success rate.
Comparison to the manual process
The bot reduced the time to update each claim to 2 minutes, compared to 10 minutes manually.
Cost Saving
The bot minimized administrative tasks for the staff which led to reduced billing and cost savings.
Technology Used
