Medical Coding & Claims Processing Automation

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Medical Coding & Claims Processing Automation

About the Client

Automated mundane, manual process of medical coding validation and processing

Business Problem

The customer was struggling to verify health insurance eligibility for potential customers due to a lot of manual processes involved in medical coding and revenue cycle management workflows.

Challenges

  • Redundancy of the data
  • Manual Processing of the data and medical codes tagging
  • High Probability of human made errors

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 behalf of them
  • 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)
  • Run UAT and feasibility before the go-live stage

Benefits

  • Reduced errors
  • Systematic file storage facility
  • Easy data extraction through OCR tools

Results

  • 98% reduction in the processing time of insurance Claims with accuracy rates close to 97%+

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