Case Studies: EOB/EOP & Correspondence Letters
The mission of Modernizing RCM with AI is to bring to our readers news, trends, and insights on how Artificial Intelligence, Deep Learning, Machine Learning, and other technologies are advancing the revenue cycle management and healthcare payments industries.
We've presented information from myriad industry sources, but we would be remiss to not present real-world cases studies of electronification -- with tangible results -- that you are can relate to your organization. We performed a number of discussions with our clients and created 3 Unique Case Studies of Platform Modernization, presenting their challenge and how technology has translated into business value:
Client Profile #1: RCM Cloud Servicer
Challenge: Legacy Vendor, Operational Gaps, and Operational Visibility
This organization had struggled with their existing offshore BPO vendor. This vendor provided paper EOB conversion to 835 management for over 10 years via the use of an extensive data entry network of keyers. The RCM Cloud Servicer realized a need to automate and address operational gaps including: process visibility, cost, reliability, process controls, and posting errors — an ongoing problem for healthcare providers and their patients.
Client Profile #2: US Headquartered BPO and Consulting Company
Challenge: Overcoming a Legacy Platform and a Challenging Labor Environment
This organization also struggled with their existing offshore BPO vendor. This vendor provided paper EOB conversion to 835 management for over 10 years via the use of an extensive data entry network of keyers. The RCM Cloud Servicer realized a need to automate and address operational gaps including: process visibility, cost, reliability, process controls, and posting errors — an ongoing problem for healthcare providers and their patients.
Client Profile #3: The Traditional RCM Outsourcer
Challenge: Manually Scanning and Processing
This organization faced issues regarding internal data entry processes that required their U.S.-based labor force to scan paper EOB and remittance documents, entering all transactional data while managing a complex process of excluding payers and select patient payments.
As you can see from the three profiles above, each client profile had a unique challenge. Click the button below to see how technology was key in overcoming their challenges.