Private healthcare provider saves 70% on billing costs with automation

The client wanted a more modern, automated solution

to replace their existing legacy, outdated billing processes. The goal was to enhance cash flow and significantly lower the amount of manual labour required within these areas by creating a centralised hospital billing and collections ‘hub’.

For billings automation, Innovior implemented a bot

to perform tasks within a patient management system (PMS) that would improve cash flow and lower manual effort. The artificial intelligence within the bot managed health fund compliance using pre-input rules and steps within the PMS, reducing the occurrence of write-offs and days sales outstanding (DSOs) from health fund payments.

The bot acted as the ‘health fund biller’. Once the medical team coded a medical record, the bot would follow the following steps to bill the patient’s elected health fund:

• Interpret the outstanding bills reports and filter all invoices that are deemed 'ready to invoice’ for each health fund
• Validate data by following the pre-determined business rules and steps for each health fund
• Exceptions for bills that the bot cannot process for invoicing are passed into a queue for the human billing team to action (less than ~30%)
• The bot sends all remaining invoices to each health fund (~70% of all invoices).

In under 12 months of implementing the billings bot

the client was able to centralise billing and collections in one location and add hospitals to the centralised location without adding labour costs. This resulted in a 70% cost reduction to the billings in their hospitals and improved DSO by 10 days, all while removing the risk of health fund bad debt.