IA & RPA for Healthcare Automation

Better patient care

With growing patient numbers, healthcare providers want to improve the patient experience, and that can be done with faster onboarding, more patient-clinician time, shorter wait times and faster time-to-results. Whether this means enabling a digital front door to services, offering more tailored correspondents or just getting more out of their interactions with clinicians, patients want information at their fingertips and services on demand.

New patient engagement models

Give patients the freedom to initiate their care in whatever way suits them best. From self-service portals, automated appointment scheduling and appointment reminders, self-check-in kiosks and so on, digital workers are helping patients find more convenient ways to access care that reduces the time they spend filling out paperwork and sitting in the waiting room.

Online booking system

Develop an online portal or app where patients can self-schedule appointments and see doctors’ availability.

Standardized services and communications

Regardless of the patient care setting, it’s important that patient engagement looks and feels the same across the board. By standardizing practices across your entire clinical system, you can ensure consistent experiences while remaining personalized, so patients don’t ever feel like just a number on a waiting list. Automate referral management, claims management, diagnostics and more.

Referral decision support

Automatically analyze patient data, medical history and referral criteria to provide decision support to healthcare providers. This includes suggesting specialists or facilities based on the patient's needs or insurance coverage, where applicable.

Appointment scheduling

Facilitate appointment scheduling and coordination between referring providers and specialists' offices. This includes sending appointment reminders, coordinating scheduling preferences and managing cancellations/rescheduling requests efficiently.

Diagnostic results

IA seamlessly integrates between systems, allowing for real-time updates and access to medical results. Digital workers can auto-fill data fields to reduce the number of data entry errors and they work quickly, meaning crucial data is logged sooner.

Put automation in the contact center

Empower your contact center teams to better serve patients by automating simple inquiries and creating a single source of truth for patient data established by the user. By doing this, agents are free from time-consuming tasks and now have time to focus on patient needs, and patients spend less time on the phone.

Chatbots

Patients can interact with natural language bots to schedule appointments, check availability and receive confirmation via email or SMS.

Appointment reminders

Generate and send automated appointment reminders via SMS, email or automated voice calls to patients, reducing the number of missed appointments.

Patient education

IA can engage patients throughout the referral process by providing educational resources, appointment reminders and guidance on next steps. This empowers patients to actively participate in their care journey and ensures better adherence to referral recommendations.

Prior authorization

IA can optimize healthcare prior authorization workflows, reduce claim denials from health insurers, relieve common patient access challenges, speed up patient registration and automate critical revenue cycle tasks.

Eligibility verification

Quickly verify patient eligibility and insurance coverage for specific medical services or treatments. By accessing insurance databases and patient records, IA can determine whether prior authorization is required and streamline the initial screening process.

Submission and tracking

Automated prior authorization platforms can facilitate real-time submission of authorization requests to insurance companies and track the status of pending requests. This includes monitoring for approvals, denials or requests for additional information.

Payer communications

Streamline communication between healthcare providers and insurance companies. This includes electronic information exchanges, automated notifications for status updates and electronic signatures for authorization requests, reducing reliance on manual paperwork and phone calls.

Insurance claims

Digital workers can capture key insurance claims data and input it into systems in real-time. Where claims are submitted in a structured electronic format, they’re sent to a scanning mechanism while paper-based claims are digitized. Then, digital workers can automatically sift through payer checks and balances to determine whether a prescribed medication is medically necessary and appropriate, trigger any missing data and pull the contracted medication price.

Claims processing

Automated systems can extract relevant information from claim forms, medical records and other sources, perform eligibility checks and process claims according to predefined rules and policies. This reduces manual effort, accelerates claim turnaround times and minimizes errors.

Fraud detection

IA tools analyze large volumes of claims data to identify patterns, anomalies and suspicious activities indicative of fraudulent behavior. Digital workers can flag potentially fraudulent claims for further investigation, helping mitigate financial losses.

Life sciences

By bringing IA into the lab, life sciences organizations can limit manual errors while speeding up drug development from lab to market. Digital workers take advantage of large data sets and advanced software to do things a team of scientists might take days to complete. IA augments drug discovery, preclinical research and clinical trials.

Drug discovery and development

Accelerate the drug discovery process with machine learning (ML) algorithms analyzing vast datasets and identifying potential drug candidates. Automated systems can predict molecular structures, assess drug-target interactions and prioritize compounds for further testing based on efficacy and safety profiles.

Clinical trials

IA can streamline preclinical and clinical trial processes and optimize study design, patient recruitment and data analysis to expedite new therapy development.

Supply chain management

Automate inventory management, procurement and distribution processes. IA can forecast demand, track inventory levels and coordinate logistics operations.

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Revenue cycle automation

Revenue cycle automation (RCM) gives healthcare providers access to a software platform that automates any management processes, interacting with line-of-business applications to improve communication and streamline claims submissions, back-office functions, billing and reimbursements and hospital record updates.

Patient registration

Automate patient data entry to reduce errors. IA can collect patient details accurately and input them into the system.

Eligibility verification

IA can perform real-time eligibility checks to verify insurance coverage – improving revenue capture and reducing claims denials.

Claims management

IA can generate accurate claims based on standardized code sets and payer requirements, reducing errors and accelerating claim submission timelines.

Denial management

IA can analyze denial codes, claims data and payer feedback to prioritize and escalate appeals effectively.

Billing and collection

IA can generate and distribute statements, invoices and payment reminders and can customize billing communications based on patient preferences, payment history and outstanding balances.

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