Compile medical records for denial requests and upload them to UHC to satisfy the additional documentation request and contest the denial.
DOMAIN
Revenue Cycle Back
FUNCTION
Denials & Appeals
Category
Additional Documentation Requests
Status
Live
AUTHORING ORGANIZATION
Hospital for Specialized Surgery
PERFORMANCE METRIC
Denial Write offs
Automation Tool
UiPath
TECHNOLOGIES
RPA
Applications
EPIC
UHC Portal
HB | PB
Hospital Billing
Automation value
(as reported)
29988
Problem Statement
When payers issue additional documentation requests (ADRs) on denied claims, staff must manually pull the supporting medical records and upload them through the payer portal. This is a high-volume, time-sensitive task, and submissions that lag or miss the deadline leave the claim unpaid and aging. Because payers typically pay once the additional information is provided, handling these requests accelerates cash and improves aging accounts receivable.
Automation Solution
This automation compiles the medical records tied to each UHC documentation request and uploads them to UHC, satisfying the ADR so the claim can be paid without manual handling.
Automation Resources
PDDs, Process Flows, Presentations, and Assessments
Tarpon Health - UHC Medical Records [Phase 1] - Process Definition Document
PDD
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Related Automations
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Problem Statement
When payers issue additional documentation requests (ADRs) on denied claims, staff must manually pull the supporting medical records and upload them through the payer portal. This is a high-volume, time-sensitive task, and submissions that lag or miss the deadline leave the claim unpaid and aging. Because payers typically pay once the additional information is provided, handling these requests accelerates cash and improves aging accounts receivable.
Automation Solution
This automation compiles the medical records tied to each UHC documentation request and uploads them to UHC, satisfying the ADR so the claim can be paid without manual handling.
Automation Resources
Tarpon Health - UHC Medical Records [Phase 1] - Process Definition Document
Related Automations
Comments