Gentem Health is a Silicon Valley-based company with a mission to help healthcare providers build thriving organizations by simplifying the reimbursement process and elevating the patient financial experience. Gentem accomplishes this by leveraging technology such as artificial intelligence, automation, and data to streamline and accelerate the reimbursement process.
Gentem is providing the medical billing processing service on behalf of its clients. To process the billing claim, the Company was collecting all the necessary information about the appointment, such as patient billing info or provider info, and passed the data to the appropriate medical insurance company manually.
Our goal was to organize the whole process of passing data in the fastest and safest way for all participants.
There were two main issues with the process:
Firstly, the whole process took a lot of time, engaged multiple people on the company’s side, and generated unnecessary costs for the company.
Secondly, mistakes in pulling and passing the data were occurring (since it was work done by a real human). Problems like this can put Gentem in legal danger since the data in the medical industry is super sensitive. Plus, there's also the chance of jeopardizing the relationship between the company and insurance providers.
Medical billing is a complicated and work-heavy process but is also very rule-based (in most cases) and repetitive, which are the perfect traits of a great automation candidate.
We had to focus on data from Electronic Health Records.
EHR is an application that allows storing all the data used in the health practice, like:
Patient data (basic info, contacts, medical history, medication and allergies, immunization status, laboratory test results, radiology images, vital signs, personal statistics like age and weight, and billing information
Providers' info (NPI, licenses)
Schedule appointments, etc. Most of them provide some solution for medical billing.
Our RPA developers have proposed a solution of an RPA-based integration between multiple EHRs and Gentem’s databases.
In the new process, we take the relevant data (patients, providers, service locations, appointments, service lines, payments) from the EHRs and insert it into Gentem’s database so they can process insurance claims based on the information provided.
The new system syncs the data from multiple practices that are using multiple EHRs on a daily basis.
The result of the whole process was a well-structured outcome. It gained new levels of speed and accuracy.
Thanks to our previous experience in working with medical records and EHRs we were able to understand the industry-specific challenges of the Client, as well as the sensitivity of the data we were processing. This gave us a unique angle to solve Gentem’s problems.
As a result, productivity was increased and Gentem’s team was able to take care of more important tasks, instead of manual data processing.
The company can now focus on working with patients and partners. Our UiPath developers and RPA consultants can do the rest!