Automation Saves the Hardest Work for the Pros

The Challenge

A major children’s healthcare hospital chain in the US knew that its new service line would help it better care for sick children, the organization was challenged when faced with the anticipated need to increase staffing from 350 professionals to more than 1,100 in less than a year. To increase efficiency, administrators decided to leverage automation significantly to enable its claims examiners to manage existing work plus the new workload.

Meanwhile, they saw an opportunity to address its difficulties with the required processing of a monthly data load that was error-prone, time- consuming and costly. The health organization engaged the Accodian team to increase claims processing throughput using automation.

Our Approach

Our consulting services helped validate payment accuracy on test claims and manage and monitor day-to-day activity. We also implemented our Healthcare Process Automation solution to process the low-to-medium complexity work that represents the bulk of claims received and tuned it to process many common edits.

To address the issues with the Texas 834 EDI file data load, our Electronic Data Interchange team helped clean the data and fine-tune automation processes to load the files and reduce the amount of human intervention required.