Problem Statement

Registration and demographic errors made up front cascade downstream into eligibility denials and rejected claims, and correcting them manually is repetitive. Accurate registration is what lets the resulting claims bill cleanly the first time. There is heavy overlap between the health system's patients and its health-plan members, and today each plan member has to be manually preregistered before they can be scheduled or seen, even though all the needed data already exists in the plan's Minimum Data Set file. Doing this registration by hand is high-volume work that slows scheduling and access.

Automation Solution

This automation downloads the Geisinger Health Plan Facets Minimum Data Set (MDS) file and registers GHP members into Epic without manual intervention, including creating Guarantor accounts for members under 18 from the subscriber details.