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. Accounts in the authorization and referral workqueues often lack the benefit details needed to bill and estimate correctly, so each one has to have its general benefits and collection details populated per plan and charge. Doing this manually is repetitive, and missing benefit details lead to inaccurate estimates and downstream denials.

Automation Solution

This automation pulls accounts from the authorization and referral workqueues that lack benefit details and populates the general benefits and collection details per plan and charge.