Healthcare is predicted to have a 60% automation potential. This means that close to two thirds of healthcare tasks especially managerial, back-office functions could be automated, allowing healthcare providers to offer more direct, value-based patient care at lower costs and increased efficiency.
JOLT has developed a three-phased automation approach to maximize reimbursements from insurance providers, significantly increasing staffing efficiencies, and ultimately reduce and prevent denials and underpayments.
We start by immediately automating the manual analysis work, implementing RPA to review all submitted claims and the amount paid (or not paid) by the insurance provider and flagging any discrepancies.
We focus on prioritization, leveraging RPA to sort these discrepancies by the highest amount owed to the health system. Prioritization maximizes the value for the health system by positioning the workforce to recover as much lost revenue as possible from the insurance providers.
We broaden the scope of analysis even further. RPA determines metrics such as which payors are generating the most denials, which claims were previously paid and are now being denied, the top 10 reasons for claim denial, and how many days each payor spends in accounts receivable (AR).