Problem Statement

Operational and financial reports must be pulled from the source systems, assembled, and distributed on a schedule, and building them manually consumes analyst time and delays the insight leaders need to act. Medicare Return to Provider (RTP) claims stay in the CMS mainframe rather than routing back to the EMR, so reporting on them means logging in and pulling the data manually. Each month a staff member extracts the RTP claims for each facility National Provider Identifier (NPI), builds the file in Excel, and looks up the description behind each RTP reason before leadership can review it. It is repetitive, error-prone assembly work on a fixed schedule.

Automation Solution

This automation logs into the CMS mainframe, extracts RTP claim data by facility NPI, prepares it in Excel with the RTP reason descriptions from the reference file, and saves the completed monthly file for leadership review.