This month on April 21 at 11 AM ET, Automation Expose features the First Prize winner of the 2022 IBM Build-a-Bot Challenge, Salem Hadim, Vice President of Business Automation at Prolifics. Mr. Hadim designed and project managed a team, who created a sophisticated Intelligent Automation solution for the U.S. Healthcare industry to address a significant problem.
Health Insurance Payers need to manage their costs, so they set up an approval process for surgical procedures and healthcare services. Given the complex bureaucracies that both healthcare providers and payers have created, many patients find that after a doctor has made a recommendation, there can be a significant delay in getting a green light from the health insurance company to go ahead.
This is exactly the challenge that the team at Prolifics decided to address with their RPA solution. It wasn’t out of the blue. The team had conversations with several healthcare customers, asking what are the most pressing issues that automation might help solve. By far, accelerating the preauthorization process was a leading answer.
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Once they started to break the problem down and look at the bottlenecks, it was clear that getting authorization documents processed was a leading cause of delays. So they began with a document processing strategy using IBM Automation Document Processing and IBM Datacap paired with IBM RPA to orchestrate and populate the Authorization system. They also knew that if they could help doctors understand where a preauthorization is in the system to help manage scheduling and keep patients informed, that this would be a big step towards improving the experience, especially for patients, who are often in pain or discomfort. For this, they built a chatbot.
Finally, their research revealed that a segment of pre-authorizations are urgent and need a special channel to speed them through. The team incorporated an Interactive Voice Agent to help expedite high priority cases.
They called the solution IntelliDocs, and it’s an impressive application that can deliver benefits, including less time spent on data entry, less manual work in general, fewer errors, and lower administrative costs. Mr. Hadim will show a short demo of the solution in action and spend some time discussing the team’s strategy and process, including design decisions, workarounds, and lessons learned. Then we’ll open the floor to any and all questions from the audience. It’s what Automation Expose is all about. I hope to see you there.
Here's a short demo of the solution created by Prolifics...
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