Automation, AI and Denial Management

Pre-built integrations, Machine learning and AI techniques, Document AI, Data Integration and Analytics capabilities could be smartly reused by/for Hospitals and enterprise clients helping them build integrated applications in a much faster pace.

Hospitals deal with humongous data from disparate sources, forms, and periods due to their heterogenous growth history. Multiple health systems and electronic health record systems, and revenue cycles including Value based and Fee for Service using UB04, HCFA 1500 are very common in a hospital eco system.

Hospitals manage their revenue cycles using their own in-house billing departments, and do outsource part of their work due to workload surges and non-availability of qualified resources.

Hospitals often merge or acquire other smaller hospitals or buy out Private practices and groups. Every one of them have their own eco-system for smooth operations and optimal patient care. But this divide becomes a great challenge for the management and decision-making staff.

Due to all the above challenges, its been a nightmare for hospital administration to track and receive the reimbursements that they rightfully deserve from the Insurance payors and the patients. And hence the ageing report of any hospital stays bulky, and the hospital administration had to do annual write-offs to keep that surging account receivables under a fictional control.

HealthOmation with its architecture of being able to communicate with any health system or software application via a variety of interfacing protocols and techniques; and with its unique data normalization and modelling methodologies, helps hospital billing and finance departments to view their entire revenue cycle related data in a unified View and hence strategize the work allocation, fix priorities, pluck drains, take control of outsourced work, monitor productivity and efficiency and hence realize improved reimbursements.

Automation helps liberate valuable human resources doing a repetitive and mundane tasks increasing their longevity in the organization ; and Machine learning and artificial intelligence helps resolve many denials and claim scrubbing issues increasing the overall reimbursements ratio.

Our solutions are available in a Subscription based model, White labelled model or as a Turnkey solution project. Reach out to one of our hospital billing experts to talk about your challenges, and how we could be a solution!


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