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Healthcare provider saves 138,000 hours in their Revenue Cycle Management (RCM) business 

COVID-19 Challenge

Healthcare provider experiencing backlogs forcing additional work hours

Due to a poor business process outsourcing (BPO) experience, the cash application process was taken back in-house and staffed to manage all Commercial and Medicare claim adjustments. Peak volumes often created a backlog forcing 2-3 hours of weekly overtime and weekend work. Due to interoperability between the bank and the Epic EMR system, manual electronic data interchange (EDI) extraction was required for a significant volume of cash adjustments.

Solution

In 6 weeks, the healthcare provider has redesigned the process to start with RPA. It uses EDI Activity to extract cash details, orchestrates robots to meet peak demand, deploys, and scales across 2 cash teams, resulting in real time adjustment of 98% of claims in Epic EMR. This has resulted in 3-day improvement in Days Sales Outsourcing (DSO) and 138,000 hours saved and redistributed to work Denials and Credits.