Problem Statement

A defined set of payers require notification of the patient's discharge date for claim processing, and those accounts route to a Utilization Management workqueue for support staff to handle. Each one is worked manually. Staff confirm the payer is primary, generate the discharge summary from a templated phrase, and fax it to the payer. It is repetitive work on data the EMR already holds, and a notification that goes out late puts the claim at risk.

Automation Solution

This automation works the discharge workqueue, confirms the account carries an in-scope payer as primary, inserts the templated phrase that generates the discharge summary with the discharge date, and faxes it to the payer through the EMR's communication function, with no payer portal or external fax system involved.