Case Study
Provider verifies Medicare insurance eligibility
Results
2K+hrs
Over 2,000 hours saved annually
100%
100% data entry error reduction
Speed
Reduced cycle time
Company Profile
Regional federation of mission-driven not-for-profit community hospices, operates as a partnership of multiple member organizations preserving locally-rooted hospice care by providing shared administrative, IT, clinical, and back-office services. Distinct counter-position to private-equity-led hospice consolidation, supporting tax-exempt nonprofit hospice care for thousands of patients and families annually.
Challenge
Manual insurance verification
This provider serves and cares for hospice patients who may be eligible for Medicare insurance in addition to private coverage. However, the process for determining a patient’s Medicare eligibility required ongoing manual review for changing circumstances and updates to the patient’s EMR (electronic medical record) documentation.
The billing team wanted to automate the Medicare insurance verification for hospice patients to save time and reduce data entry errors.
Solution
Automated Medicare eligibility checks
The WonderBotz automation solution uses NetSmart electronic medical record (EMR) and the organization’s data warehouse to identify patients being served. Next, it uses myAbility to evaluate patient’s current and prior circumstances to determine eligibility for Medicare insurance. The results are added to the patient’s EMR for use by claims and billing teams, and non-Medicare insurance outcomes are flagged for review by the Billing team.
The solution reduced data entry errors by 100%, and reduced cycle time, saving over 2,000 hours annually.
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