THE CLIENT:
Our client is a nationwide insurance provider for 100M+ people and offers support at every stage of life. Our client offers health plans and behavioral, clinical, pharmacy, and complex-care solutions that promote a whole-health approach to care.
THE BUSINESS NEED:
The workflow to receive preauthorization required repetitive and manual administrative support by the healthcare provider’s office, re-entering data and running the risk of human error. Our client wanted to automate this process as much as possible to help with provider abrasion and reduce the amount of manual administrative effort required.
WHAT GENECA DID:
Our client started a project leveraging a type of robotic process automation (RPA) technology, UI Path, to automate this process. However, this project was failing, so they brought Geneca in to take it over the finish line. We brought in a skillset in UI Path and built an automated system that would complete the workflow without the end-user having to do every step manually.
Once we completed this project, our client identified existing performance issues with their platform and determined this wasn’t the right use case for UI Path. We took a second approach to the project and built an entire interoperability platform and services to allow users to call into APIs we were hosting and automatically create cases. If the platform hit a point where it didn’t know how to proceed, it would send users a link to complete the workflow. Otherwise, it would complete the workflow without the need for human interaction.
THE RESULTS:
Automating this process reduced the amount of manual interaction required by the healthcare provider’s administrative staff, which also reduced the amount of errors. With an interoperability platform, our client could ensure the data captured in the EMR is the exact information entered by the healthcare provider’s office. Automating this process reduced the amount of time required by the healthcare provider, the number of errors identified, and the overall cost from time spent manually reviewing cases.
ABOUT GENECA:
Geneca is a custom software development company with over 25 years of experience, empowering clients to achieve exceptional growth through innovative software solutions. We specialize in creating flagship products tailored to your unique goals by carefully selecting a highly skilled team that understands both technology and business logic.
Our approach begins with a complimentary consultation, followed by the creation of a custom experience inventory, which provides complete transparency and control throughout the software development lifecycle. Unlike many in the industry, we maintain a 97% success rate for delivering projects on time, on budget, and on expectation by fostering strong partnerships and committing to excellence in every aspect of custom software development.