Automated Manual Process of Medical Coding Validation and Processing
Overview
The customer is a U.S based software company which provides medical revenue cycle management services. The Company offers medical billing, coding, collection, reimbursement, and data management services.
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Challenges
Trouble in verifying health insurance eligibility for potential customers due to a lot of manual processes involved in medical coding and revenue cycle management workflows.
Data coming from various sources including Excel, PDF, website, etc.
Redundancy of the data.
Manual Processing of the data and medical codes tagging.
Solution
- Created a Process Design Diagram for both End of Day and End of Month
- Setup the Infrastructure using Orchestrator, Elasticsearch and Kibana
- Supported the client by doing End-to-end coding and testing on their behalf
- Performed unit testing
- Created a flow to split the PDFs based on the keywords
- Set up the hospital system automation process for the End-users
- Deployed 10 robots on VDIS (5 for test & 5 for production)
- Ran UAT and feasibility before the go-live stage
Outcomes
- Reduced errors
- Systematic file storage facility
- Easy data extraction through OCR tools
- 98% Reduction in the processing time of insurance claims with an accuracy rate of 97%
