Eligibility Automation Case Study

Eligibility Automation
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Improved turnaround time and accelerated process efficiency with Eligibility Bot Challenge:

Our customer had over 200+ patients visiting daily. Each of these patients expects to be well-informed about claim benefit. In a time-consuming and error-prone process, our customer was required to extract individual claim details from various insurance carriers. There’s no direct PMS integration existing with insurance carriers, so our customer was not able to pull patient’s data and retain it internally.

Moreover, for each scheduled appointment, front desk staff were required to manually check an insurance carrier website, to obtain claim information of their patients, which was a time-consuming process. If claim benefits are not verified, patients may forego due benefits, negatively impacting overall experience.

So, our customer turned out to BPK Tech to streamline and automate their eligibility verification process. We built an automated solution to fully automate their eligibility process.

Here’s how BPK Tech improved the turnaround time and enhanced process efficiency with Eligibility Bot.

Our Solution:

BPK Tech’s automation has helped in reducing the risk of manual errors, improving overall process efficiency, and allowed our customer’s staff to spend more time focusing on patient care. As a result, our customer benefited from excellent turnaround time. Moreover, our automated solutions enabled our customer to easily check claim status with just a few clicks.

Our Process:

BPK Tech drew on its deep expertise in custom software development to design an automated solution that fully automated DSO’s complete eligibility process.

  • Extracted appointment patient API from the PMS system and stored it in the Azure database.
  • Logged into insurance carrier’s website to search for patient details such as first name, second name, DOB, and search for eligibility and save the data as PDF.
  • Consolidated the output reports (service history, verification eligibility) into one PDF and again saved them in the Azure database.
  • Used job scheduler to write back the extracted PDF into PMS.
  • Finally, extracted count, PDF generated count, and inserted count as a final report.

We’ve developed an EHR platform that is based on the latest standards and codes to support all integration (Eligibility Check, Electronic Payment, Electronic Prescription) and interoperability requirements.

Key Benefits:

  • Improved turn around time
  • Reduction in manual work
  • Data accuracy
  • Increased efficiency
  • Improves patient communications
  • Helps to increase case acceptance

Utilizing BPK Tech’s Eligibility bots to replace manual tasks, our customer improved turnaround time by automating the process of checking claim eligibility across many insurance carriers.

Leveraging our BPK Tech’s Eligibility bots, you can streamline the process of managing insurance eligibility. Our automated bots can speed up data processing for eligibilityand avoid errors.

Ready to improve your turn-around time? Then, schedule a demo with us so that we can explain the features of our Eligibility bots to help your Verification/Billing/AR business processes.

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