Automation in healthcare industry

Automation in healthcare industry

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  q Use Case -Automation in Healthcare Industry Organization/sector - A leading healthcare service provider in its region. Operating for last 33 years, they operate Country’s largest private health care network with specialized hospitals in multiple countries. Objective – To cut costs and waste, improve efficiency and throughput. Automation of manual tasks for performance improvement Solution – Optimization through Automation using OpenSpan IT Support is provided for Job Failure Monitoring. A job is a batch process which is run in a software application to apply the actions like Claim payment, Update user data in EMR/EHR, and Issue multiple Cheques in batch. All the jobs are monitored by IT department and incase of failure steps are taken to restart the job A Process where Auto-adjudication of claims is already in place however there are numerous claims which fail the auto adjudication process. There are multiple error codes which are designed in the Auto-adjudication system. These claims are then further manually adjudicated by team by referring SOP documents or plan benefit documents Medical Records of Clients (Hospitals) are saved in electronic format. Further support like User/Patient ID creation, A/C Information, Change requests etc. are handled on daily basis. It requires keying the data into the system and pulling out the information for different purpose Healthcare IT ServicesHealthcare Management ServicesHealthcare Professional Services
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  Because of themanual nature of this process, the challenges identified are as follows:      High Operational Expense Increased risk of human error Time consuming, monotonous, and repetitive tasks Frequent deviations from the SLA High Training Cost MULTIPLE APPLICATIONS PROCESS GUIDELINES COMPLEXITYSCATTERED INFORMATION  Log-in into disparate applications Different user credentials for multiple applications Long log-in procedure for mainframe applications Auto log-off from application    Lengthy tasks Different Knowledge banks/Cheat-sheets Error prone process Difficult to understand      Multiple scenarios Different logics/calculations Repetitive data entry Long training duration Manual gaps and complex navigation Information available in different screens/tabs Multiple Alt-tabs Multiple copy-paste Time taking activity       
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  Solution - OpenSpan Fetch Data from disparate applications  Universal Agent Capability  Eliminate:  Automate authorization processing  Copy and Paste  Stop suspected fraudulent claims  Rekeying of Data  Perform duplicate claims checks  Toggling between Applications  Change data formatting  Automate validations/calculations  Minimize Data Entry  Automate edit checks Benefits Time Savings: Reduction in the manual processing and hence saving on time and effort for claims processing Cost Savings: Automating the tasks leads to faster claim processing, faster information exchange, error free payments which give high operating margins, thanks to much leaner teams through the automation. Ensuring Service Availability: Automation reduces turnaround time and increase the capacity of service requests. It has a capability to process claims any time of the day, thus ensuring 24*7 availability. Better Customer Experience: The automation helps the Insurance companies eliminate the chances of manual error, as there is least/no manual intervention in any of these activities and that leads to Better customer experience. Ensured Process Compliance: All the steps in any of the tasks adhere to the compliance requirements of Process.