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ROBOYO X LEADING HEALTHCARE PROVIDER

Delivering Next Level Claims Processing

Mar 31, 2023 | < 1 min read

HOW ROBOYO HELPED A MAJOR US HEALTHCARE PROVIDER PROCESS PATIENT CLAIMS MORE EFFICIENTLY

Our client, a major US Healthcare provider started their RPA journey in early 2019, purchased UiPath platform technology, and engaged with a system integrator for strategy and implementation of the Claims Processing Automation for the Insurance Eligibility & Optum Authorization process.​ However, the original system integrator’s strategy was flawed and not driving any results, 6 months passed, and there were zero automations in production. C-level executives were not seeing any return on their investment and the idea of killing the entire RPA project surfaced.

In just two weeks Roboyo deployed a team of 24 highly qualified, UiPath certified resources, and within 12 weeks nine automation solutions were in Production resulting in $570,000 in cost savings.

 

Our client: The client is the Northeast’s premier supplier of world-class physical, occupational, and hand therapy, operating 200 outpatient physical and hand therapy centers in the US.

Impact

YEARLY SAVINGS

Roboyo created nine automations that yielded $570,000 in cost savings for the company.

ELIMINATED

The company reduced offshore manual labor ($5/transaction) thanks to this automation.

SPEED

Roboyo developed and deployed nine automation processes into production within just 12 weeks

01

CHALLENGE

Our client needed a way to process patient claims quickly and reduce human error in the claims process. The data validation required across disparate systems, paper forms, websites, and applications of record made the process disjointed and slow. At the same time, the websites, and applications the client leveraged for patient eligibility and benefits validation changed monthly.

The Insurance Eligibility & Optum Authorization process required data collection, comparison, and validation, before processing the patient transaction in the applications of record. Any record that was not able to be validated generated an “exception” to the logic rules used in the automated process. Exceptions were delivered to human employees for quick verification.

02

SOLUTION

Roboyo stepped in to develop and deploy a series of six automations that coordinated the data pulls by patient or group and validated the data by performing the human actions to collect website-based data for comparison. After 2 weeks of initial assessment, Roboyo deployed a team of 24 highly qualified, UiPath certified resources, to work with the client team to finalize requirements for redeploying the processes (carriers), translating the functional process documentation into a robust technical design and Solution Design Document (SDD). Within 12 weeks Roboyo deployed 9 processes in Production.

The monthly application and website changes forced the client to be reactive in transaction processing. Automation was able to scale to help the client through the changes and Roboyo’s Managed Services team was engaged to receive exception alerts through the autonomic monitoring system. This identifies business and application exceptions in transaction records and queues them up to the Robotic Operations Center’s development team through incident management to adjust automation rules or logic. This enhanced the automation and engaged the client application development team to work through data structure or application changes.

03

OUTCOME

After deploying 9 automation processes into production within just 12 weeks, Roboyo continues to support and maintain these automations in a managed Robotic Operations Center, providing control, monitoring, incident management, release management, bot healthchecks, and performance reporting. Most recently, the suite of dispatcher, scraper, and processor robots for the healthcare client was enlisted to process end-of-year eligibility checks for 5,500+ patients, expediting a process that would have taken significant manual labor to accomplish. In just 72 hours starting December 29th, the automation solution checked the records for over five thousand patients, making sure the patients could continue treatments and receive benefits without interruption by January 1st, 2021.

Roboyo continues to solution additional automation processes that add value to the client’s business, providing support of the automations in production from our Robotic Operations Center, while at the same time, continuing to assess more high ROI process candidates for automation to keep scaling the benefits of automation across the enterprise.

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JOLT

IS NOW A PART OF ROBOYO

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In a continued effort to ensure we offer our customers the very best in knowledge and skills, Roboyo has acquired Jolt Advantage Group.

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AKOA

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In a continued effort to ensure we offer our customers the very best in knowledge and skills, Roboyo has acquired AKOA.

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LEAN CONSULTING

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In a continued effort to ensure we offer our customers the very best in knowledge and skills, Roboyo has acquired Lean Consulting.

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In a continued effort to ensure we offer our customers the very best in knowledge and skills, Roboyo has acquired Procensol.

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