Problem Statement

When a patient is admitted, the payer must be notified within a tight window, often within a day or two of admission, or the stay is denied regardless of whether the care was necessary. Sending each Notice of Admission manually is labor-intensive and easy to let slip while staff focus on the admission itself, and a notice that goes out late, or not at all, becomes an avoidable denial on an inpatient stay the organization has already begun delivering. Where BCBS exposes an API, the notice is submitted programmatically rather than through portal screens.

Automation Solution

This automation submits Notice of Admission notifications via a BCBS API and updates the electronic medical record to inform staff of successful submissions.