A healthcare giant is using AI to sift through millions of transactions. It's saved employees 15,000 hours a month.
For "CXO AI Playbook," Business Insider takes a look at mini case studies about AI adoption across industries, company sizes, and technology DNA. We've asked each of the featured companies to tell us about the problems they're trying to solve with AI, who's making these decisions internally, and their vision for using AI in the future.
Omega Healthcare Management Services is a revenue cycle management company that helps more than 350 healthcare organizations, including providers, payers, and pharmaceutical companies, manage their financial operations.
This includes medical billing, insurance eligibility verification, collections, clinical documentation, and other administrative tasks. The company, which was founded in 2003, is headquartered in Boca Raton, Florida. It also has teams in India, Colombia, and the Philippines.
Situation analysis: What problem was the company trying to solve?
Omega Healthcare has more than 30,000 employees who perform a high volume of administrative tasks, including medical billing and insurance claim submissions, for healthcare organizations. Every year, they process about 250 million digital transactions. These tasks have traditionally been done manually.
Rajusiva Arunachalam, the company's vice president of technology, said that the administrative tasks are mundane, repetitive, and time-consuming. "We have a lot of humans working in the background for these doctors and providers who help them do their non-clinical work," he said.
Arunachalam said Omega Healthcare wanted to automate billing, insurance claims, and other administrative tasks to free up employees to handle decision-making aspects, such as when to deny claims or follow up on a late payment. The goal was to improve its operations and help its clients increase collections, minimize incorrect claim submissions and denial rates, reduce receivable payment times, and enhance patient engagement.
Key staff and partners
Omega Healthcare partnered with UiPath, an enterprise automation and AI software company, about five years ago to automate some of the workers' manual administrative tasks, including billing, medical coding, and correspondence with insurance companies. Arunachalam said UiPath's platform was a good fit for Omega Healthcare's strategy, which focuses on boosting automation and speeding up the completion of clients' administrative tasks.
Arunachalam said Omega Healthcare created an internal team made up of developers, business analysts, and data scientists. The group focused on finding opportunities to automate repetitive tasks to save employees' time while speeding up work for clients.
AI in action
Omega Healthare uses UiPath Document Understanding, an AI tool that automatically pulls data from various client documents, such as accounts receivable correspondence, insurance denial letters, or electronic medical records. Arunachalam said the AI tool extracts data from these documents based on what a healthcare institution is trying to accomplish.
For example, if the task is to file an insurance claim, the AI tool may pull out relevant data from electronic medical records. Or, if a claim was denied, it may identify relevant data from a denial letter or transcript of a call about the case.
Arunachalam said human staff members review the data extracted by AI and use it to make decisions. For instance, they may decide that a claim was denied incorrectly due to a medical coding problem or based on information from a medical record. Staff can also use the tool to follow up with a healthcare company for more information on a billing error. Employees then send their decision to the client.
"Human work is now more knowledge-based, very decision-oriented," which AI technology can't do, Arunachalam said. But humans and AI "work together in conjunction to achieve what the client needs."
AI "can run 24 hours," Arunachalam said. It can also process data much faster, so fewer employees are needed for this work, which is more cost-effective for clients.
Arunachalam added that Omega Healthcare has automated its administrative tasks, such as submitting insurance claims and medical billing, for about 60% to 70% of its clients.
Did it work, and how did leaders know?
Since 2020, Omega Healthcare has processed more than 100 million transactions using UiPath automations, Arunachalam said.
Omega Healthcare tracked the time it took employees to manually complete different administrative tasks and compared it to the time they spent on them after adding UiPath's tool to measure the tech's impact. Arunachalam said the company found that automation was saving employees more than 15,000 hours a month.
Arunachalam said Omega Healthcare has also reduced the amount of time workers spend on documentation tasks by 40%. He added that automation has also slashed document processing turnaround time by 50% with a process accuracy of 99.5%.
The company told BI that these improvements have increased efficiency and cost savings for Omega Healthcare's clients, delivering a 30% return on investment since using the AI-powered automation.
Arunachalam said Omega Healthcare is working on automating more of its client work, including payment posting and patient appointment scheduling.
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