How Nalashaa's Automation Revolutionized Urology Healthcare—And Tackled a Tax ID Twist with Flair!
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Introduction
A top Urology Healthcare Facility in the US partnered with Nalashaa to automate their Eligibility Verification Process, slashing verification time by 98% and boosting revenue by 5%. With RPA handling business rules and system exceptions, incomplete claims and non-payments dropped by 20%.
However, when one facility in the network changed its tax ID, it became crucial for Nalashaa to develop another RPA solution to identify appointments linked to the facility with the new Tax ID and route them for human intervention, while allowing the rest to continue through the EBV bot without a hitch.
The Looming Challenge
It is estimated that between 3% to 10% of healthcare claims are denied due to incorrect or missing information, including incorrect Tax IDs. These denials lead to payment delays, costly rework, and can rack up thousands or even millions in losses for healthcare facilities.
When Tax ID mismatches began causing business exceptions, the previously efficient EBV bot faltered, requiring urgent intervention, as 20% to 30% of appointments were not being processed correctly. Nalashaa needed to swiftly understand all the relevant parameters in the appointments to correctly identify the facility with the updated tax id and implement an RPA solution that replicated the process flawlessly—no errors, no delays.
A Bot-Tastic Breakthrough
The ingenious minds at Nalashaa developed a bot that could scan six months of upcoming appointments to stay ahead of the EBV bot, which was only focused on the next seven days. The bot was designed to cleverly use a combination of Provider id, Insurance details, facility name, and the updated tax ID to identify appointments needing human intervention and those that didn’t, sorting the appointments into two separate buckets.
The bot wasn’t just about doing the heavy lifting; it also knew how to keep everyone in the loop by generating a snappy report of its accomplishments, making sure no one missed a beat.
Key Highlights
On an average, a human can handle only 240 records in a day Through the bot, a backlog of about 5,0000 appointments significantly decreased, with only 350-400 new appointments being added each day.
Benefits
Nalashaa embarked on a journey to integrate client’s D365 platform with DocuSign, leveraging the robust capabilities of both systems by developing a comprehensive solution:
This new bot boasts an impressive 95% success rate.
On average, the bot updates each appointment in just 1 minute and 15 seconds, nearly cutting the time in half compared to the 2 minutes a human would need.
Freed up administrative staff to focus on more critical tasks, reducing the burden of routine work.
Technology Stack
