Automation for Third Party Administrators

Robotic Process Automation for Third Party Administrators

Which processes do I Automate?

Healthcare Claim Payment from a health insurer to a healthcare provider either directly or via a financial institution (EDI 835) is used to make a payment, send an Explanation of Benefits (EOB), send an Explanation of Payments (EOP) remittance advice, or make a payment and send an EOP remittance advice only.

These simple processes cover a large amount of manual work in reconciliation –

  • Verification of claims
  • Matching of claims
  • Carrying out adjustments
  • Highlighting disputes
  • Modifying Patients or Payer Charges
RPA suitable processes

These processes are rule-based, high volume, stable and with structured inputs, making them apt for automation!

An auto-adjudicated claim costs 75% less in processing,
generating over $1 billion savings for $3 billion claims filed/year – Analyst Research

Applications of RPA

Claims reimbursement is the biggest source of revenue for most practices. A RPA tool provides a quick and accurate solution when dealing with volume, complexities of payer contracts, insurance company rules, coding and filing, claims tracking and more.

Benefits of RPA

RPA savings, robot future

Let’s get started

Speak with a specialist to assess your automation score and business process ROI on a RPA implementation.

What is / is not RPA?

RPA benefits, bots efficiency