Robotic Process Automation

for Eligibility & Benefit Verification

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About the Client

A large physician practice based out of the midwest had issues with front desk processes that impacted their revenue cycle operations. Faced with an increase in errors and a loss of revenue, they turned to Vee Technologies to streamline their insurance eligibility and benefit verification processes.

Problem

Issues with front desk operations can negatively impact the rest of the revenue cycle process as the claim makes its way to the payer and adjudicates. From initial contact, this client would manually verify patient insurance eligibility consistently for three days, or until all verification-related processes were complete and documented. Utilizing manual resources, the operations team would process an average of 500+ patients each day, adding resources as necessary to complete the task.

As with any manual process, accuracy is dependent upon the number of allotted resources and the time each resource is given to complete the task. Faced with a growing attendance issue and a lack of necessary resources, error rates increased and negatively impacted operations throughout the rest of the revenue cycle process.

Solution

Seeking to eliminate their front desk issues, Vee Technologies was contacted to identify a solution that could solve the client’s operational constraints. Robotic Process Automation (RPA) was implemented to collect the eligibility information and up-to-date benefit amounts from the payer sites. From there, the bots would compile the information and create the appointment notes, then update the information in the practice management system as necessary.

The implementation phase would run for two months prior to deployment. With the eligibility & benefit verification process corrected, resources could then be diverted to other parts of the revenue cycle to enhance operations and solidify the rest of the processes.

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Result

Capable of running 500-800 records per day without the need for human interaction, eligibility-related claims denials reduced by 70%. Additionally, the rollout of RPA resulted in 25% cost savings for the organization within the first year. With an eye on innovation, this client turned to RPA to streamline their operations and drive revenue. The benefit was not only noticed in their revenue cycle operations, but had an increase in patient satisfaction as well.

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