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Industries: Healthcare, RCM
Provider Systems: Epic
Payer Portals: eviCore, United Healthcare, Magellan
Challenge
A large healthcare provider needed to ramp up their automation strategy to offset labor instability and attrition. Currently the staff manually have to go out to payer portals, submit requests and check statuses of Prior Authorizations, sometimes multiple times. Through Task Mining AI (Artificial Intelligence) analysis, it was determined that staff were spending about 30 – 40% of their time submitting requests and checking the status for 19,000 prior authorizations per month.
Prior Authorization Requests: 3 bots processing prior authorization requests in 3 separate portals (EviCore, Magellan and UHC).
- EviCore: 923 transactions per month
- Magellan: 595 transactions per month
- UHC: 7,063 transactions per month
Prior Authorization Statusing: 3 bots processing prior authorization statuses in 3 separate portals (EviCore, Magellan and UHC).
- EviCore: 5,536 transactions per month
- Magellan: 3,572 transactions per month
- UHC: 986 transactions per month
Solution:
RPA bots are a much more accurate and effective solution to verify the status of patient health authorizations, RPA bots can repeatedly check requests under review for status changes and updates.
CampTek Software was engaged because of its healthcare and Epic experience. Through task mining, AI models were created, and results were reported back to the customer with enormous success. The next phase of design and build all occurred in a brief time. The bot now in production includes business rules, exception handling and daily reporting functionality. It is also supported by CampTek as an ongoing managed service solution for the provider.
The Bot is now saving 2,696 FTE (full-time employees) hours per month or 32,352 hours (about 3 and a half years) per year. The FTE capacity gain is 17 FTEs (full-time employees), and the ROI (Return on Investment) is $1,085,000 per year.
Sample Recording: Prior Authorization Request in EviCore
As part of the solution, CampTek Software also provides Customizable Executive Dashboards for each bot in production so that customers can see powerful and actionable analytics data on their automation success.
About CampTek Software
CampTek Software is a Full-Life-Cycle RPA SaaS Provider. With industry experience developing and supporting RPA Applications since 2005, we have the expertise to support any Automation initiative you can think of. CampTek will be with you on every step of your RPA Journey. With our unique background, we are qualified to develop and support any RPA Process. We offer Advising Services, Host Support and Bot Support for all production processes. Our unique hosted model offers many powerful advantages including a shorter time to market, 24/7 support and overall lower cost of entry.
