Digital Coworker Use Case:
Verifying Patient Insurance Information

A customer of ours is a company that eases access to basic reproductive healthcare, which had a team of 14 FTEs responsible for manually verifying the insurance coverage of its subscribers. Collecting and verifying patient insurance information is time consuming, and health insurance is complicated and changes frequently, and they wanted to improve this process.

Roots Automation's Digital Coworker has enabled the company not only to scale automatically to meet demand, but the bot has enabled the company to improve customer acquisition rates and reduce customer acquisition costs.

Industry: Healthcare
Department:
Insurance
Challenge

Individual details, insurance plans, and prescription information must be correct, or the patient could face a delay in receiving healthcare. The customer's typical turnaround timeframe for insurance verification was an entire business day. In addition, the information was only 65% accurate, which was well below the quality assurance team’s ideal number.

Once a month, the 14-person staff repeats the entire process for every patient to ensure that payer information is accurate. This redundancy is necessary, but requires a hefty time commitment.

Problems
Collecting patient insurance information is time consuming.
Collecting patient insurance information is a simple but labor-intensive endeavor. Individual details, insurance plans, and prescription information must be correct, or the patient could face a delay in receiving healthcare.
 Solutions
Digital Coworkers read patient ID cards from just a photo.
By simply sending a photo of the patient’s ID card by text or email to the Digital Coworker, medical care providers see a 90% straight-through processing rate starting day 1. Digital Coworkers significantly reduce dependence on manual data entry.
Verifying info required , 24 hours and  2-4 days to turnaround shipments.
The customer's typical turnaround timeframe for insurance verification was an entire business day. In addition, the information was only 65% accurate, which was well below the quality assurance team’s ideal number.
Insurance details and eligibility are verified in less than a minute.
In 60 seconds or less, healthcare staff receive a response from the Digital Coworker verifying the patient’s insurance information.

The fast response ensures timely and quality care.
Health insurance is and complicated and changes frequently.
Once a month, the 14-person staff repeats the entire process for every patient to ensure that payer information is accurate. This redundancy is necessary, but requires a hefty time commitment.
Information is checked periodically
and unprompted.
The Digital Coworker repeats the process frequently and automatically, ensuring that the hospital team always has accurate and up-to-date information.

Outcomes

Roots Automation implemented a Digital Coworker to support the customer's insurance verification process in only 2 months. The bot reduced the time required to verify a subscriber's insurance from one day to one minute, with an accuracy rate greater than +90%. Additionally, the timeframe for shipment was reduced from 4.5 days to less than 2 days, and only required a 2-person team to support the bots, compared to 14 FTE previously.

Critically, the customer is growing at 20,000 subscribers a month. Roots Automation's Digital Coworker has enabled the company not only to scale automatically to meet demand, but the bot has enabled the company to improve customer acquisition rates and reduce customer acquisition costs.

Email us at sales@rootsautomation.com for more info.
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