Pain Treatment Centers of America:

How we automated insurance claims processing, freed up 4FTE per month and achieved 100% ROI in 23 days

Client:

Pain Treatment Centers of America

Location:

Arkansas, USA

Industry:

Healthcare
RPA

Team:

2 senior RPA devs, Lead Architect

Technology:

UiPath

Timeframe:

7 months (ongoing)

Pain Treatment Centers of America

2 weeks

Of development

100%

ROI after 23 days of running the project

4 FTE

Saved monthly

$180k

saved (just with the initial launch)

Client

Pain Treatment Centers of America (PTCoA) is Arkansas’s largest fully comprehensive pain management practice network, with 13 clinics in Arkansas and Mississippi.

PTCoA offers cutting-edge pain management techniques by trained professionals and several of the most advanced Surgery Centers in the region. They also offer IV sedation monitored by trained anesthesiologists.

The Challenge

PTCoA came to us with the mission of streamlining insurance claims submission processing.

The process consisted of completing insurance claim forms by providing information about referring providers, adding relevant ICD codes, selecting location and business units, and sending them to insurance providers.

Prior to our collaboration, the entire process was executed manually by a dedicated 4-person team. Shortly speaking, it was an expensive and lengthy process for PTCoA. It was also exposed to human errors, which made it even longer and more costly.

PTCoA needed our help in changing that.

The Solution

After understanding the pain point of the client, we mapped the process in detail and moved to select the perfect automation platform.

From the very first conversation with the PTCoA team, we noticed the enormous potential for building a larger, automation system. That’s why we recommended implementing UiPath – the top RPA platform that allows easy scaling and building of multiple automation bots.

To be 100% sure that automation will serve its purpose, we provided PTCoA with a free Proof of Concept, that validated the feasibility of the automation.

After the PoC got approved by the Client, we started with the RPA development. For the purpose of this project, two RPA bots were created:

Dispatcher

Dispatcher automatically extracts an unprocessed claim from the PrognoCIS platform used by the PTCoA clinics (PrognoCIS is a cloud-based EHR software designed to streamline workflow and increase the productivity of medical practices) whenever it appears in the system.

Performer

Performer mimics the actions of a human worker in the actual process. The bot would open and complete the claim with relevant patient data, add ICD codes, assign the right business unit, and send the claim to the insurer.

The Outcome

In two weeks, we managed to implement the first version of the bot, significantly cutting down the time needed for the execution of the process. Now, a single claim is processed in less than 45 seconds, without human error.

Shortly after the project kickoff and first bot deployment, we managed to save 4FTEs for the client, as the process is now executed without the need for human intervention. Furthermore, the process execution time dropped by 50%, further improving PTCoA’s Revenue Cycle.

With the low costs of development ($5,000 consulting fee and license costs of $14,000), the project achieved a 100% return on investment in 23 days, projecting $180,000 worth of savings after year one.

We are already working on the next processes (automation of pharmaceutical matching and processing prescriptions & drug orders) with five more next in line, such as processing outstanding claims, sending automated e-mails, and automated price comparison.

We are proud to see that Pain Treatment Centers of America entered the path of process automation. We are happy to accompany them on this journey, pave the way and help them get closer to the final goal – providing the best patient care possible, with a flawless back office and superfast client service.

 

2 weeks

Of development

100%

ROI after 23 days of running the project

4 FTE

Saved monthly

$180k

saved (just with the initial launch)

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