Problem Statement

Coverage and benefit details must be confirmed and entered accurately before billing, and doing this manually at volume is slow and error-prone; gaps that slip through surface later as eligibility denials, inaccurate estimates, and avoidable rework. A daily benefits report arrives from Optum and has to be turned into account notes in the exact format operation's needs, then filed to the right patient accounts. Reformatting and filing that report manually each day is repetitive, and delayed benefit notes hold up accurate estimates and clean billing.

Automation Solution

This automation consumes the daily Optum benefits report, creates account notes in the operations-required format, and files them so they sweep into the appropriate patient accounts in STAR.