Intelligent Automation for Healthcare Industry: Overview & Use-Cases

Use-Cases of Intelligent Automation in Healthcare

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Patient-Physician Appointment Scheduling

Scheduling a patient-provider meeting is critical to a healthcare system’s smooth operation. While websites and applications provide an interface for arranging appointments (day, time, and physician availability), intelligent bots give a more personalized experience. They can make recommendations based on symptoms, list relevant physicians who are available and nearby, and collect information to arrange an appointment and more. Patients can communicate with the bot at any time to reschedule appointments and enquire about insurance benefits, location, and prices, among other things. Essentially an IA-integrated appointment scheduling system alleviates the challenge of patient no-shows and manual data entry.

Procedures for Discharge Automation

Discharge procedures usually take a long time and are arguably one of the most frustrating phases a patient must go through. Using a patient management system (PMS) can simplify and make this less time-consuming. IA can be deployed to automate the discharge cycle, including transcribing post-discharge instructions such as prescriptions, follow-ups, recommendations, and getting approval from hospital staff and more, based on the patient information collected in the PMS. Overall, IA reduces the efforts of administrative staff and increases the ability to manage patients more eficiently.

Management of Insurance Claims and Billing

Processing and settling insurance claims is a regular occurrence and requires precision. Manual processing is prone to an error rate of at least 10%, which requires additional rework. Although an employee of the insurance provider might take just 5–10 minutes to verify the claim status of each applicant, it adds up to a considerable number which is eventually reflected in the amount that healthcare providers and patients pay as premiums. Because most of the tasks involved in claim management are rule-directed, it is the best candidate for Intelligent Automation. The following tasks can be performed by a bot used to automate claim processing:

Management of Inventory

Intelligent Automation can help in the management of non-clinical operations too. Gloves, medication, needles, syringes, and their supply are typically kept track of by payers. Backed by ML-driven data analytics, Intelligent Automation can accurately forecast demand and supply patterns and can assist in maintaining an ideal inventory level. Aside from inventories, an automated rule-based engine can also handle hospital rooms and other resources.

Management of Regulatory Compliance

Compliance is always a top priority for healthcare companies. Non-compliance will cost healthcare providers dearly. Ensuring that all regulatory requirements are met, especially concerning Patient Health Information (PHI), is critical for legal, regulatory, reputational, and financial reasons. Intelligent Automation can implement role-based access controls (RBAC) to ensure unauthorized personnel do not access patient data. Intelligent bots collect data to the granular level, making it much easier to generate reports that need to be submitted for audits.

Payment Processing

Intelligent automation can improve coordination between healthcare and insurance providers and aid healthcare providers reimburse faster and more seamlessly. The reimbursement journey collates various data from disparate sources such as patient medical history, premium payment history, diagnostic codes and multiple other factors. IA can also automate the extraction and aggregation of data, format it as required, and submit claims for processing in no time.

Clinical Workflows and Patient Journeys

The main aim of automating clinical processes is to provide respite to physicians and other hospital staff from the rigor of repetitive tasks, which significantly erodes the time they spend attending to patients. IA is more than capable of performing these essential routine tasks for positive patient outcomes. It gathers data from multiple sources and instantly transfers them from one application to another. It makes all of the required data in a particular location, providing easy access and eliminating the scenario where physicians need to wait for information from different departments, which in turn helps them make informed decisions faster.

Healthcare Insurance Personalization

Data collected through automation assists payers in making better healthcare decisions, allowing them to provide better patient care. Automation can be used for patient segmentation based on the data collected. This allows insurance providers to create personalized healthcare plans that help them serve their patients better.

Payoda as your Automation Partner

Intelligent automation is a successful recipe for healthcare organizations to mitigate costs and improve the quality of processes, such as developing and maintaining provider networks, supply chain prices, risk management, marketing and sales, patient journeys, and claims and billing processing. Our IA techniques are efficient and precise, can work 24/7, increase productivity and free up healthcare staff to provide excellent experiences for patients.. Talk to our experts at Payoda to learn more about how to accelerate your healthcare digital transformation through automation services.



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Payoda Technology Inc

Payoda Technology Inc


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