CHALLENGE
This client has a big staff of doctors, nurses, and medical assistants dedicated to wound care practices service. They provide their services to patients in their homes and residents in long-term, subacute, and supportive living facilities. They serve approximately 100 of these facilities throughout Australia and treat 1,500 patients weekly.
Fast and accurate payment by Medicare is an important process aspect for all healthcare providers. Manual analysis process of clinical documents—charts and notes—and code determination being related to a particular case were very tedious and time-consuming. Or this process had to be handled manually by a devoted and experienced programmer.
Over 50,000 codes fall into different categories to generate proper invoices daily. The changes associated with such complexity, inaccuracies in medical coding, delay the overall operation and also lead to improper payments.
This customer wanted to eliminate potential loss of revenue from inaccurate coding. Moreover, from a revenue cycle management perspective, it was crucial that the coding for billing was done quickly and with 100% accuracy to avoid rejection or non-payment of claims.
APPROACH
Adactin implemented RPA Bots to automate hundreds of charts each week easily and efficiently. With native machine learning abilities, bots understand, analyse, and create wound and prescription documentation for each patient and generate a billing code that produces a suitable invoice.
The billing/payment process is accomplished via an external billing company, a dedicated system, or managed in-house. This automation reduces the risk of manual errors and improves the efficiency of the entire process.
As a result, the medical staff can focus more on patient care and more complex coding scenarios.
OUTCOMES & BENEFITS
- Manual Work Reduced by 95%
- Coding Accuracy Improved to 90%
- Shift Time Process Reduced by 80%
