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Points of Light 2023 Case Study 6
Using API and RPA Technology to Optimize Claims Monitoring
Author
Boyd Stewart
Author
Aurene Wilford
To reduce the manual work associated with claims monitoring, the partners in this case study collaborated to combine API technology from the payer with robotic process automation (RPA) technology from Waystar. Claims statuses are then normalized and delivered directly into the healthcare organization’s EMR workflows, resulting in greater claims visibility and a reduced administrative burden for all parties. As a result of this collaboration, the healthcare organization has also seen reduced denials and faster payment collection.
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Key Findings:
- Executive Summary
- The Collaborators
- Points of Friction—Challenges to Be Solved
- Action Plan—How the Collaborators Worked Together to Reduce Friction
- Points of Light—Outcomes Achieved through Collaboration
- Lessons Learned—What Best Practices Can Other Organizations Replicate?
- What's Next?—Vision for the Future
Writer
Elizabeth Pew
Designer
Jess Wallace-Simpson
Project Manager
Joel Sanchez
This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2024 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.