R SYSTEMS
Dr
. Samiksha Mishra speaks about R Systems ’ visionary AI technologies and progressive work culture industry , a simple thing like billing has become a very complex process — especially in the US . It was estimated that we spend almost 10 % of the overall amount of healthcare dollars in the administrative processes , and the majority of that is associated with the billing process , and related insurance verification and claims .”
He also explains that many critical procedures — such as patient insurance eligibility checks , advanced authorisation of treatments , identifying post-treatment billing codes , denial management , and claim settlements are currently fulfilled manually in many healthcare provider organisations .
“ 60 to 80 % of that is done manually today with most healthcare providers . After the
“ In the healthcare industry , a simple thing like billing has become a huge monster ”
HIREN KOTAK VICE PRESIDENT AND GLOBAL HEAD OF INTELLIGENT AUTOMATION PRACTICE , R-SYSTEMS claim is submitted , it ’ s not a simple process to obtain the payment . There are often questions , denials and appeals . There are various things that a provider needs to do to receive the payment ,” he explains . “ All of this involves interdependent tasks that we have now successfully automated for our clients .”
Meanwhile , in the financial sector , the same business model applies . In any regulation intensive industry , like banking , there is a high number of menial tasks that consume a significant amount of time . Alleviating the manual input — or at least most of it — can provide significant efficiency gains and cost savings .
Kotak says that “ in the traditional banking environment , the account opening
162 December 2021