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. Medicare claims require the patient's Medicare Beneficiary ID, but it isn't always on file, so staff have to take each patient's demographics, look the patient up on a payer site, and retrieve the MBI before the claim can go out. Doing this lookup by hand across a workqueue is repetitive, and a missing MBI holds up the claim.

Automation Solution

This automation uses an Epic workqueue export and an API to pull patient demographics, retrieves Medicare Beneficiary IDs from UHC and Palmetto eServices, and stages the values on an import spreadsheet for loading into Epic.