Challenge:
Drowning in manual financial tasks, a leading healthcare technology firm turned to Novatio, revolutionizing operations with automation that slashed effort, boosted accuracy, and maximized savings.
The firm struggled with processing underpayment claims across multiple payers, requiring 15 hours of manual effort daily. Each payer had unique workflows in the Availity application, making manual claim submissions cumbersome. Logging into various systems, updating data, and creating disputes led to frequent delays and errors. Without a scalable solution, integrating new payers and workflows was inefficient, straining resources and limiting financial performance.
Objective / Need:
- Streamline the underpayment reconsideration process to reduce manual effort.
- Standardize workflows across multiple payers with unique systems.
- Improve processing speed, accuracy, and scalability while reducing costs.
Solution:
Novatio introduced the firm to an Intelligent Automation solution to streamline underpayment reconsideration. The BOT was initially deployed for three major payers—Aetna, UHC, and Humana—before scaling to accommodate ten additional payers, each with unique processes.
The automation securely accessed payer systems, retrieved necessary data, and processed reconsideration claims with minimal manual intervention. By standardizing workflows and ensuring real-time tracking, the solution reduced processing time from hours to just minutes per claim while enhancing accuracy and compliance.
Outcomes:
With the automation in place, the firm’s 15 hours of daily manual effort was eliminated across facilities, significantly boosting productivity. Errors in claims processing were minimized, ensuring timely payments. The scalable framework seamlessly integrated new payers, making it future proof for evolving needs. Additionally, operational costs were significantly reduced as financial teams could now focus on higher-value tasks instead of repetitive claim disputes.
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