- Medical data retrieval and extraction is a challenge due to lack of data and technology integration.
- Provider has to dedicate resources for manually extracting and reviewing patient medical data critical for claim preparation.
- Dealing the medical PDF documents that are unstructured because of no such fixed templates.
PATIENT DATA EXTRACTION
Accurate data extraction enables Healthcare providers to enhance care and reduce expenses. Reliable data extraction limits errors and allows access to essential information to assist patients and Healthcare providers. Autosphere robots can assist in providing quick but accurate diagnosis and treatment plans.
Problem :
Solution:
Autosphere bots can extract and optimize patient data more effortlessly while communicating with other digital systems. Additionally, Autosphere IDP service intelligently detect and extract patient data from PDFs document while keeping human in the loop for reviewing and authorizations.
Outcome:
- 80% reduction of manual work
- 70% reduction in AHT
- 45% deduction in operational costs
Appointment Scheduling
Autosphere robots can book appointments with the best type of Healthcare provider based on the diagnosis, location and other considerations. Missed appointments time and costs are saved with reminders by bots
Problem :
- Healthcare contact centers are burdened with the inbound requests for setting appointments as a result this requires a significant increase in agent headcounts at call centers.
- While the healthcare core systems do not provide necessary APIs for integrations resulting in inability to provide customer service through any other channel.
Solution:
Autosphere Bots with cognitive capabilities to serve patients in appointment scheduling. Patients can interact through a voice or chatbot to locate the nearest store or to book an appointment very quickly.
Bots interact on existing legacy system interfaces to: locate nearest provider for the customer, check availability of appointment slots for a specific date and time make/change/remove appointment, locate the status of a customer service request.
Outcome:
- 80% reduction of manual work
- 70% reduction in AHT
- 45% deduction in operational costs
Eligibility Check
Autosphere speeds up health insurance eligibility checks while reducing errors that can occur with human actions, due to the volume of patients
Problem :
- Healthcare provider are required to check patient’s insurance eligibility details from various legacy applications.
- There is no direct integrations with insurance carriers and insurance benefits change regularly.
- Healthcare providers are bound to perform this repetitive and error prone process because if eligibility is not verified, patients may forego due benefits, negatively impacting overall experience.
Solution:
- Autosphere bots can query information from multiple insurance carrier websites and download eligibility details in required format.
- Bots can communicate status updates at completion and log information on exceptions.
Outcome:
- 95% Data accuracy
- 60% Increased efficiency
- 70% Improved data auditability
Prior Authorization
Autosphere can cut out the middle man and directly coordinate with insurance providers for quicker authorization of reoccurring health claims.
Problem:
- Healthcare providers have to dedicate resources to check for prior authorization requirements by insurance provider for procedures and prescriptions.
- This is repetitive process and applies for all patients in scenarios where authorization is compulsory. Request forms are to be filled which requires information collection from multiple sources and sending the request to specific insurance provider.
Solution:
Autosphere bots can check for prior authorization requests for every patient, check for validations on insurance portals and prepare request forms that are required to be submitted to insurance providers.
Outcome:
- 80% FTE reduction
- 70% improvement in prior authorization AHT
- 90% error reduction in submissions
Automated Medical Coding
Reduce errors and streamline coding operations
Problem :
- Manually analyzing clinical documentation and determining codes to a specific case is highly tedious and time consuming for healthcare providers.
- Coders are required to deal with this manually with over 70,000+ codes that are used to generate proper invoices.
- There are chances for inaccuracies in medical coding which have an impact on revenue.
Solution:
Autosphere bots can be used to code thousands of charts with ease and efficiency and streamline coding operations to ensure error free submissions
Outcome:
- 95% Reduction in manual work
- 90% Improvement in coding accuracy
- 85% Improved process turnaround time
Automated Claim Processing and Management
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Problem :
- Claim processing is a time-consuming and error-prone task which requires collecting data from different sources.
- Approximately 1/10 claims are denied for simple reasons like missing data or some claims are denied due to untimely filing.
- Resources also need to repeatedly check for claim status and manage claims that have been denied.
Solution:
Autosphere bots can automate the entire claim application process and additionally check for status and manage denied claims for re-appeal.
Outcome:
- 90% Error reduction leading to improvement in approval rate
- 70% Improvement in claim handling time
Data Backload from legacy to modern systems
Autosphere has the flexibility you need to update data and keep it secure as it is upgraded.
Problem:
- Healthcare systems rely on discrete data stores which poses a challenge for migration to newer systems.
- Because the APIs for legacy systems don’t exist; a migration requires engagement for costly services.
Solution:
- Autosphere bots are used to migrate and validate content as it leaves the legacy system.
- Integrate data from multiple systems to bring legacy data in line with primary clinical systems.
Outcome:
- 70% increased migration speed
- 90% error reduction
