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. Many registration errors follow simple, well-defined rules, but they still have to be worked one at a time before the affected accounts can bill. Resolving these rule-based edits by hand is repetitive, low-judgment work that backlogs and holds accounts from billing.

Automation Solution

This automation resolves simple, rule-based Epic registration errors across the configured workqueues, built to scale as additional queues and rules are added.