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Healthcare providers across the industry are integrating intelligent automation into a variety of areas within their operations. Through advanced technologies such as robotic process automation (RPA) and artificial intelligence (AI), providers can help reduce operating costs, increase efficiencies in operations and provide better patient experiences.

The below use cases explore a variety of ways healthcare providers can leverage intelligent automation technologies to add value.

Third party insurance claim status

Providers can help streamline the third party claims process through implementing a standard rules-based automation technology. By streamlining this process, providers are able to gather real-time data from payer portals to “hot route” account workflows. This gives providers the ability to drive activities to the next most appropriate and knowledgeable worker as efficiently as possible as well as reduce the amount of full-time employee (FTE) intervention.

Treatment authorization obtainment

Providers that are trying to obtain authorization through the phone or online often need to meet certain conditions, with some information needing to be transmitted back and forth. Automation technology can help reduce the amount of time employees spend collecting this information. Although automation can only go so far, it can save significant time for the employer by collecting basic criteria before needing to bring in a knowledgeable worker to assist further.

Third party rejection/denial auto processing

Providers can use an unattended, cognitive machine learning system to streamline non-routine tasks requiring judgment to be performed entirely without human intervention. By utilizing AI technology solutions, providers are able to quickly go into an electronic medical records (EMR) database, grab specific data, package it up and present it to a knowledgeable clinic worker to auto appeal specific denials and pull information from various sources to compile an appeal.

For more information about intelligent automation or to learn how Baker Tilly’s Value Architects can assist your organization, contact our team.

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