About the Client
The client is a Third-Party Administrator (TPA) who focuses on physician services, as well as practice management and healthcare products. The exclusive services are provided to health insurance carriers, TPAs, brokers, employers, and directly to healthcare consumers.
For this particular workflow, the organization ensured previous payments were processed accordingly for their clients, if the payment was correct, an invoice was generated and submitted to the payer. Generating these invoices for each service line across the spectrum of clients was 100% manual, with workload increasing as the company was growing exponentially. As new clients were added throughout this process, accuracy issues became prevalent. When issues arose, the process of identifying, quantifying and correcting the errors became a time-consuming task. To combat the issue, additional quality controls were established, further complicating the workflow and slowing down production. Errors became too abundant and it became obvious that it was not feasible to continue operating this way.
Almost immediately, the quality of completed work rose to 95% accuracy. Any remaining issues could be monitored and adjusted quickly with a minimal workforce. The bots were able to process around 100 groups per day, far more than had been previously achieved. An extremely complex process that required 10+ FTEs was automated to reduce the required FTEs by half, increased productivity and accuracy, and drastically increased client satisfaction. As the company growth continued, additional bots were deployed throughout the organization, allowing strategic growth and available FTEs to take on additional workloads effectively.