Healthcare
“63% of healthcare providers have faced severe disruptions due to reasons including internal organizational changes, cost pressure, regulation and compliance, funding, or shifting consumer demands.” - Gartner
Post-pandemic, the healthcare industry’s growth has been either smooth or fluctuating. The system has gone through a more extensive digital transformation. The usage of digital technologies has increased to meet the patients’/customers’ expectations. Technologies like automation and process intelligence enhance the operations area of the industry. Factors like Medical claims processing, revenue management, and documentation are handled with our solutions.
BUSINESS CHALLENGES
Payer
Medical claim processing involves many complexities in variables, including patient information, insurance coverage, and medical codes. Errors in patient or insurance information can lead to inaccuracies such as incorrect claims, resulting in delays or denials of payment. Detecting and preventing medical claim fraud is a significant challenge in the healthcare industry. Many requirements and complying with these increased regulations can be a challenge for payers. Payers are responsible for managing the cost of medical treatment for their members. Data Management related to patient treatment, insurance coverage, and medical codes can be a challenge.
Provider
The COVID-19 pandemic challenges healthcare providers with the need to provide treatment to patients and the impact on revenue due to reduced in-person visits. The widespread adoption of telemedicine in response to the pandemic has led to a shift toward virtual care. Reimbursement for medical services includes declining reimbursement rates and the need to navigate complex billing and payment systems. Patient satisfaction challenges are related to providing high-quality care and managing costs by complying with regulatory requirements. A shortage of healthcare workers results in recruiting and retaining a sufficient workforce.
Hospital & Primary Care Services
Challenges related to patient experience include offering good care while facing costs and complying with regulatory requirements. The healthcare industry faces a shortage of workers, and hospitals and primary care providers may face challenges in recruiting and retaining a sufficient workforce. Ensuring data accuracy while managing large amounts of data related to patient registration and treatment is challenging. Condensing revenue cycle management activities to improve cash flow can be a challenge to hospital services. Patient onboarding involves numerous processes for healthcare workers from registration to discharging.
OUR SOLUTION
We offer customized solutions with Hyperautomation and Process Mining to boost the operational excellence of the Healthcare industry. With our solutions, streamline the processes and identify the process bottlenecks to boost business productivity, customer experience, and operational efficiency.
Business Process Intelligence
Process mining uses data analytics techniques to analyze and improve business processes. In the healthcare industry, process mining solutions can help hospitals and primary care providers in 2023 by identifying process inefficiencies, improving patient care, reducing costs, enhancing compliance, and improving decision-making.
Identify Process Inefficiencies
Process mining solutions can help hospitals and primary care providers identify bottlenecks, delays, and other inefficiencies in their processes, enabling them to optimize and streamline these processes.
Improve Patient Care
By analyzing data on patient outcomes and treatment processes, hospitals and primary care providers can use process mining solutions to identify opportunities for improving patient care and outcomes.
Reduce Costs
Process mining solutions can help hospitals and primary care providers identify opportunities for cost reduction, such as by identifying unnecessary or redundant processes and streamlining them.
Enhance Compliance
Process mining solutions can help hospitals and primary care providers comply with regulatory requirements by identifying and addressing any issues related to processing compliance.
Improve Decision-making
Process mining solutions can provide hospitals and primary care providers with insights into their processes, enabling them to make more informed decisions about optimizing and improving their operations.
Hyperautomation
Hyperautomation uses advanced technologies, such as artificial intelligence (AI), machine learning, and robotics, to automate business processes. In the healthcare industry, hyperautomation solutions can help hospitals and primary care providers in 2023 by improving efficiency, reducing errors, enhancing patient care, reducing costs, and enhancing compliance.
Improve Efficiency
Hyperautomation solutions can help hospitals and primary care providers streamline and automate their processes, reducing the time and effort required to complete tasks and freeing up staff to focus on more value-added activities.
Reduce Errors
Hyperautomation solutions can help to reduce the number of errors that occur in tasks such as data entry, billing, and coding, which can lead to improved patient care and increased revenue.
Improve Patient Care
Hyperautomation solutions can help hospitals and primary care providers access and analyze large amounts of data, enabling them to make more informed patient care and treatment decisions.
Reduce Costs
By automating tasks and processes, hospitals and primary care providers can reduce labor costs and improve their bottom line.
Enhance Compliance
Hyperautomation solutions can help hospitals and primary care providers comply with regulatory requirements, such as HIPAA and GDPR, by automating data management and privacy processes.
Business Process Transformation Suite
The Process Transformation Suite benefits organizations to understand, manage, and optimize business processes. Customized operational cockpits are built using Business Process Transformation, bringing real-time data and process management together. With the process mining capability, monitoring the business processes to achieve operational excellence.
SAP Signavio is a software solution that helps organizations design, analyze, and optimize their business processes. In the healthcare industry, SAP Signavio can help Providers, Payers, Hospitals, and Primary care providers in many ways, and a few are highlighted below.
SAP Signavio can help hospitals and primary care providers streamline the process by identifying and eliminating bottlenecks, delays, and other inefficiencies and improve process efficiency. By analyzing data on patient outcomes and treatment processes, hospitals and primary care providers can use SAP Signavio to identify opportunities for improving patient care and outcomes. SAP Signavio can help hospitals and primary care providers identify opportunities for cost reduction by identifying unnecessary or redundant processes and streamlining them. Hospitals and primary care providers comply with regulatory requirements by identifying and addressing any issues related to enhancing compliance.
Benefits
Reduce Operational Costs
Optimize the Process
Decrease the Processing Time
Improve Process Efficiency
Business Cases
PROCESS MANAGEMENT
Leading healthcare companies encounter challenges related to providers like escalating costs, heavy regulations, etc. The company aims to decrease the cost with technologies but at the same time, patient care should remain unaffected. With BTP, the operational processes and policy regulations of the company are optimized. The outcomes include statistical data for observing and enhancing patient care by reducing the processing time.
Benefits
Standardized Ops Processes
Optimized Regulations
Cost Reduction
Reduce the Processing Time
with our expert and start your transformation journey today.
Execution Management System
Celonis Execution Management System (EMS) amplifies the performance level for the company to succeed with the available time and resources. Companies experience breakthroughs in execution capacity by involving process analytics, artificial intelligence, and automation. EMS comprises execution instruments, execution applications, a developer studio, and an EMS store to eliminate execution gaps and maximize execution capacity. EMS is used across industries such as healthcare, manufacturing, banking and financial services, etc.
Celonis believes that every company can unlock its full execution capacity. Powered by its market-leading process mining core, the Celonis Execution Management System provides a set of instruments and applications, the Celonis Studio as well as platform capabilities for business executives and users. The Celonis EMS offerings help companies manage every facet of execution management from analytics to strategy and planning, management, actions, and automation.
Celonis can help hospitals simplify the claims process by identifying and eliminating inefficiencies, delays, and other inadequacies and help in improving productivity. By analyzing data on patient outcomes and treatment processes, hospital providers can identify opportunities to enhance patient experience and provide valuable outcomes. Celonis can help primary care providers identify opportunities for operational cost reduction by identifying unnecessary or redundant processes and streamlining them. Celonis improves decision-making with insights into their processes, enabling them to make more informed decisions about optimizing, and improving their operations. Celonis can help hospitals comply with regulatory requirements by identifying and addressing any issues related to processing compliance. Hospital expense categories such as procurement and inventory necessitate more agility and resistance.
Benefits
$12M Cost Savings
25% Time Reduction in Claims Processing
35% Decrease in Onboarding Time
15% Reduction in TAT
Business Cases
ACCOUNTS PAYABLE
Healthcare companies with thousands of employees struggle with various ERP systems which results in a lack of process standardization. Organizations intend to have higher business productivity, better cost saving, and augmented working capital in the accounts payable process. With EMS, business cases have been developed and novel electronic invoicing platforms have been introduced to enhance the overall Days Sales Outstanding (DSO).
Benefits
62k Automated Billing Blocks
55k Rework Activities to Bridge Data Gaps
15% TAT Reduction
$10M Improvement in Working Capital
with our expert and start your transformation journey today.
Automation
Hyperautomation is a technology that helps to build, deploy, and manage software bots. RPA makes human activities easier by streamlining workflows that increase the business’ operational efficiency. While RPA does the basic automation, Intelligent Process Automation (IPA) includes advanced technologies such as Artificial Intelligence and Machine Learning along with RPA. Intelligent Document Processing is a technology that extracts and processes data from various sources such as PDFs, handwritten documents, etc. UiPath’s Document Understanding uses bots to extract data using AI. Conversational AI involves chatbots to instantly connect with the users/customers that improvise the customer experience.
UiPath is a software company that provides various automation solutions, including robotic process automation (RPA) and artificial intelligence (AI). In the healthcare industry, UiPath solutions can help Providers, Payers, Hospitals, and primary care providers in many ways, and a few are highlighted below.
UiPath's automation solutions remediate process efficiency by helping hospitals and primary care providers to automate tasks such as data entry, billing, and coding. Hospitals and primary care providers improve patient care by automating tedious processes like appointment scheduling and prescription refill requests. UiPath's automation solutions can help hospitals and primary care providers minimize labor costs by automating tasks currently done manually. Compliance Adherence for hospitals and primary care providers to comply with regulatory requirements by automating data management and privacy policies. UiPath helps the hospital’s care management with systems interoperability for an extensive view of patients’ health history.
Benefits
15% Higher Patient Revenue
30% Productivity
25% Cost Savings
30% Faster Execution
Business Cases
PROVIDER DATA MANAGEMENT
Manually updating the provider data in the database is a tedious task. Data processing involves manual efforts and errors and consumes time. Automating data entry and processing in the fund application using automation tools boosts the processes in the healthcare’s back office. Using bots to update demographics, location, Tax ID, Tax provider, etc., improvises data accuracy. Executing centralized monitoring and reporting of the robot execution aids the data process.
Benefits
$225K Cost Savings
100% Data Accuracy
3 Number FTE Savings
100% Reduction in Manual Effort
CLAIMS MANAGEMENT
A high volume of claims is processed daily which consumes major manual efforts. Manual claims processes involve errors in data processing which affects the process efficiency. This challenge is rectified by analyzing and automating the processes that involve higher manual effort. Data extraction, data scraping, and data validation with IDP eliminate the errors involved in claims data management. Automating the claims process boosts process efficiency and reduces manual effort and time.
Benefits
25% Cost Savings
30% Faster Execution
30% Productivity Lift
15% Higher Patient Revenue
PATIENTS ONBOARDING
Patient registration with details inside the Epic and re-entering into another place becomes a repetitive task when manually executed. Manual form processing also requires a lot of time and ends up with errors. Using a bot, we automate the registration process from the existing information. Automation reduces errors in data validation and provides an efficient patient onboarding process. This digital workflow benefits the organization with increased revenue and improvised productivity.
Benefits
75% Decrease in Denials due to SLAs
$6M Potential Gain
30% Fraud Reduction
25% Reduction in Unnecessary Tests
