Vertical | Healthcare

Referral Intake Automation

Streamlining Multifaceted Referral Intake with Intelligent Bots

About this Project

Managing referrals from hospitals across 17 states, with over 50 distinct portals, presented a unique challenge for a large home health organization. Each branch had its specific payer relationships, adding another layer of complexity to the process. Our mission was clear but demanding: Design a system that seamlessly automated the intake of these diverse referrals. Our solution? A team of bots trained to mimic human patterns and decisions. These bots were tasked with gathering referrals from myriad sources and funneling them, in a structured manner, into the organization’s electronic health record system. Beyond just gathering, the bots also standardized the data, preparing it for human review. As an added layer of sophistication, we crafted algorithms to evaluate the capacity of each branch. This allowed for strategic decision-making based on resource availability at every branch at any given moment.

Our Team

Solutions Architect: Chalked out the automation strategy for referral intake, ensuring integration with the EHR system.

Developer & AI Developer: Worked in tandem to develop the bot capable of data extraction from semi-structured PDFs and subsequent data entry into the EHR.

Tester: Validated the bot’s functionality and ensured its accuracy in a real-world environment.

Domain & Technology

  • Microsoft Power Automate
  • Azure SQL
  • Azure BLOB Storage
  • Open AI’s GPT
  • Langchain

Results

The introduction of the bot has significantly reduced manual efforts in referral processing. Its capability to seamlessly extract and integrate data into the EHR has transformed the referral intake landscape. In its next evolution, it will incorporate advanced intelligence to proactively evaluate patient eligibility across different payers. This will further refine the referral acceptance process, aiming to ensure that referrals accepted early in the process endure seamlessly through the revenue cycle management phase, minimizing rejections and optimizing operations.

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