Health Processes Automation

The healthcare industry is continually looking for improving operational efficiency, reducing cost and automating manual tasks as part of the overall strategy for performance improvement. LTM has deep experience in automation using RPA tools like UI Path, Automation Anywhere, etc.
LTM has successfully automated healthcare processes covering member enrollment, provider empanelment and credentialing, prior authorizations, claims adjudication and revenue cycle management for large Healthcare customers in different geographies.

Our recent experience with one of the US east-coast based large insurance company was to automate all their manual back office operations using AI driven RPA in the following areas;

• Manage the member enrolment during the AEP, group updates issues, PCP updates which errored out during enrolments
• Handle the COBRA renewals and terminations
• Handling inpatient and outpatient claims that were rejected as part of claims adjudication cycle

Services Offered

• Data extraction from various documents like prior authorization request form, appeals forms or paper claims, leveraging OCR/ICR, NLP and ML
• Identify automation possibilities in business-critical workflows across healthcare modules. For example; member enrollment, provider empanelment & credentialing
• Cognitive automation of entire process using AI led extraction of data, BOT implementation, creation of automated workflows with “Human-in-the-loop” to healthcare processes like claims re-adjudication, applying premium payments from bank lockbox
• Omnichannel access to all healthcare ecosystem partners

Key Features

• Artificial intelligence driven robots to accelerate human intensive, repetitive tasks
• AI led rule-based data extraction to process structured and un-structured data
• Cognitive classification of document and images based on visual characteristics
• Human-in-the-loop (HITL) verification to augment services offered by virtual assistants

Business Benefits

• Eliminate repetitive and routine tasks performed manually by process simplification, automation and elimination
• Reduce the access time while collaborating between the legacy systems and new age applications
• Decrease average handling time of mundane tasks to improve TAT
• Mitigate the risk associated due to un-availability of niche skilled resources