Objective: To automate the current Manual Direct Medical Billing Process which is intended to reduce human effort, reduce human intervention, achieve high accuracy, avoid/minimize human errors, reduced rework.

 

Solution: HR/CMO collects data via phone call and submits relevant data on to web form and generates Referral Letter which is automatically sent to admin of concerned hospital.

Once the patient gets discharged from the hospital, the hospital accounts department will send mandatory documents in pdf format to PSU as an attachment to concerned stakeholders at PSU for settlement.

Accountant (PSU) receives email and BOT will extract all the documents like Discharge Summary, Detailed Bills, Medicines Bills, Lab Reports and Bill Summary and extract data from these documents automatically from the mailbox of a concerned stakeholder and stores in an excel sheet.

BOT will carry out verification and validation of all these documents and classify the same as valid/invalid, included/excluded, discounted/non-discounted, admissible/non-admissible and also checks whether the individual bill amount is as per agreed tariff with concerned hospital and finally arrive with the amount to be paid to the hospital.

The bot logs in to the SAP system automatically and creates a remittance voucher and sent to the authorizer for review and once reviewed and authorized it will be sent automatically for approval from the concerned stakeholder of PSU. Once a Remittance Voucher is approved with a digital signature, the remittance voucher will be sent to the concerned stakeholders in the Payments Department.

 

Benefits: Reduced Human Intervention, Improved Accuracy, Reduced Rework, Improved Throughput (Reduced Cycle Times), Flexibility & Scalability, Better Employee Morale, Improved Audit Trail, Improved Vendor Satisfaction & Better Integration with IT systems.