Revolutionizing Healthcare Billing: How Dr. Soliman Fakeeh Hospital Transformed Their Manual Processes with Robotic Process Automation
For over three decades, Dr. Soliman Fakeeh Hospital (DSFH) has been at the forefront of healthcare delivery in Saudi Arabia, setting new standards for excellence through its pioneering spirit and visionary resolve. Founded in 1978 by Dr. Soliman Fakeeh, DSHF currently operates four facilities across the Kingdom, with plans for further expansion.
The Challenge
DSFH currently has 4 facilities (hospitals, medical centers, and care centers) across the Kingdom and is expanding into other facilities. Most encounters are billed via insurance companies which is a highly manual process. DSHF was facing a significant challenge with its billing process, which relied heavily on manual data entry and insurance submissions. This led to a high risk of errors and an increased risk of rejections from insurance companies.
The Solution
Advansys offered an automation solution that boosted Dr. Soliman Fakeeh Hospital’s billing process, unlocking exceptional accuracy and speed in insurance submissions. Our multi-faceted approach targeted four key areas for ultimate efficiency
- Verifying Patient Data: This was a crucial step in the process, as any inaccuracies in patient data could lead to rejected claims. The solution employed Optical Character Recognition (OCR) technology and Robotic Process Automation (RPA) to extract key information from national IDs and verify it against the data in DSHF’s Health Information System (HIS).
- Updating Table of Benefits: Insurance companies regularly update the benefits offered by their policies, and DSHF needed to ensure that it’s HIS reflected these changes in order to correctly bill patients and submit claims to insurance companies. The solution employed RPA to check for updates on insurance company portals and to make the necessary updates to DSHF’s HIS.
- Checking Insurance Eligibility: With over 100 patients visiting DSHF daily, it was essential to check the insurance eligibility of each patient to ensure correct billing. RPA was used to fully automate this process and run it several times per day to accommodate both prior appointments and walk-in patients.
- Reviewing Claims: Before submitting claims to insurance companies, DSHF’s finance team audited the submissions to ensure all essential information was included. However, with over 10,000 claims daily, the process was tedious, and the team was not able to review every claim. The solution employed RPA to review every single claim daily and report any missing or invalid information to the relevant team for correction prior to submission.
Through this comprehensive solution, DSHF was able to streamline its billing process, reduce errors and increase the speed of insurance submissions, leading to a more efficient and effective healthcare delivery system along with an enhanced patient experience.
