How a leading provider of Revenue Cycle Management software transformed revenue optimization with intelligent business automation

Thousands of U.S. healthcare enterprises depend on our clients’ revenue cycle management software to help them guide patients through a seamless payment experience, increasing their satisfaction, and loyalty, and helping providers achieve their financial goals.

The
Results

Improvement in RCM Agent KPIs

60-80% Improvement in RCM Agent KPIs

90% Reduction in error rates

Claims Denial Rate 90% Reduction in error rates

Days to Final Bill

Days to Final Bill

HIPAA Compliant processes

HIPAA Compliant processes

Medtronic

“Medtronic in India has different ways of reaching out to our customers. One of them is direct supply to the healthcare providers. There is a lot of complexity involved in this like managing the inventory, associated purchase orders, consumption metrics etc. The integrated capabilities for handling workflows, data, dashboards and web application front-end enabled us to streamline the overall operations effectively.”

Gartner Report
Garter prediction

Garter prediction

Gartner predicts that by 2025, over 50% of healthcare tasks will be automated, leading to improved operational efficiency and better patient experiences.

The Challenge: Reducing complexity and manual data entry

As a trusted Revenue Cycle Management solutions provider, our customer faced an intricate problem of escalating complexity in their medical coding function. Their process relied heavily on the manual labor of RCM agents who painstakingly sifted through unstructured data from medical records, extracting relevant details and assigning codes. This traditional approach not only tested the boundaries of the coders’ productivity and efficiency but it also led to a high incidence of errors. The business urgently needed a scalable solution to handle the growing complexity of medical coding tasks, enhancing efficiency and significantly reducing error rates.

The Power of EvoluteIQ: Transforming Medical Coding with AI and an Operational Cockpit

EvoluteIQ HyperAutomation in Medical Coding, Operational Cockpit by EvoluteIQ

In response to this complex challenge, EvoluteIQ developed an innovative solution that fundamentally transformed the medical coding process. Drawing from the powers of Intelligent Automation, they redesigned the workflow into an automated, data-driven model, integrating Computer Assisted Coding and Explanation of Benefits (EOB) processing. This solution revolutionized how medical coding was conducted, ensuring accuracy while dramatically reducing the time and labor traditionally required.

Further, the solution wasn’t just innovative; it was extensively scalable, serving as a unified, integrated automation platform with a user-friendly interface for over 5000 RCM agents. The platform supported multi-tenancy, providing each of the BPO company’s clients with a secure workspace. This allowed for a seamless operation, with every client having their own dedicated and secure space within the same platform, ensuring confidentiality and collaboration.

A unique feature was the addition of an “Operational Cockpit”, designed exclusively for BPO supervisors. This powerful tool provided a comprehensive overview of all their business Key Performance Indicators (KPIs), with the capacity to drill down data on a client-by-client basis. The cockpit ensured efficient monitoring and empowered the supervisors with actionable insights, aiding in strategic decision-making and ensuring optimal performance. With this transformation, EvoluteIQ delivered an efficient, scalable, and integrated solution that addressed the complex business challenge head-on.

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