Problem Statement

Claims and remittances have to move between the billing system and the Medicaid portal on a daily cadence, and when no automated file feed exists, someone has to upload the claim files and pull the payment files by hand every day. It's routine but time-sensitive, and a missed or late transfer holds up both claim submission and the cash posting that depends on the remit.

Automation Solution

This automation uploads the daily Medicaid claim files, downloads the remits from the payer portal, and stages them for posting into the patient accounting system.