Revenue Cycle Management Automation

Improve efficiency of health care providers’ revenue cycle process and uplift patient care, accurate extraction across medical records of different formats

Company Overview

A leading global leading technology-driven healthcare reimbursement firm headquartered in USA with international back offices across the globe.

OVERVIEW

Scaling Verification with Agentic AI

How Botminds AI helped an enterprise eliminate manual verification bottlenecks, improve data accuracy, and enforce compliance at scale.

Business Challenges

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Redundant, repetitive tasks – checking claims status, denial appeals, etc. that involve checking records, forms & data across systems and communicating with stakeholders – patients, medical staff, payors, billing & accounting units

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Large volumes of medical records, insurance claim forms from hundreds of providers received in spurts; multiple formats of handwritten & scanned documents – this poses challenges in accuracy and turnaround times

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Manual errors causing reduced or delayed reimbursement from payers & patients due to incorrect diagnose code, imprecise eligibility estimation etc., lead to high accounts receivable for the healthcare provider

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Inability to correctly predict out-of-pocket costs vs. eligibility in the payor health plan, wrongly denied claims etc. are some pitfalls of disparate systems or a primarily manual process – leading to patient dissatisfaction

Botminds Solutions

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DA dedicated, secure, private cloud deployment of the Botminds AI platform to keep all medical and claims documents in the client’s environment

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Generic pre-trained AI models of the platform was able to handle the medical documents extraction and classification with efficiency of 60%

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The Subject Matter Experts (SMEs) were trained in less than a week to use the Botminds AI platform to further train the models leading to higher accuracy - overall onboarding was accelerated, spanning 4 weeks

BUSINESS IMPACT

Value Delivered

Quantifiable business outcomes delivered through Botminds AI-powered automation and intelligent workflows.

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Accuracy

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Process Efficiency

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Reduced Time

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Increase in volume handled

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