- Industry: Healthcare & Insurance
- Service Pillar: Intelligent Automation & Quality → Automation
Executive Summary
A regional healthcare provider faced inefficiencies in claims processing due to manual data entry and complex eligibility checks. The claims setup process led to frequent errors, claim denials, and slow turnaround times. Mindmap Technologies automated the entire claims intake and triage process using intelligent OCR, validation rules, and RPA, streamlining operations and improving accuracy across the claims lifecycle.
Problem Overview
- High volume of claims requiring manual data extraction and entry
- Frequent inaccuracies leading to increased claim denials
- Inefficient triage and routing to appropriate adjudication queues
- Limited visibility into claims processing SLAs and bottlenecks
Our Solution
- Implemented intelligent OCR and NLP-based extraction for claims forms and supporting documents
- Integrated eligibility and prior-authorization checks within the RPA workflow
- Automated claim triage and queue assignment using business rules engine
- Enabled end-to-end monitoring dashboards for claim processing and SLAs
Technologies Used
UiPath, ABBYY FlexiCapture, Python, REST APIs, Power BI
Key Outcomes
01
Reduced claim setup time by 65% through automation of intake and validation
02
Decreased claim denials due to data errors by 35%
03
Improved overall claim processing SLA adherence by 45%
04
Increased provider satisfaction scores by 11 points within six months