Patient Eligibility and benefits verification automation

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The Benefits of automating your complete RCM processes.

Illustration representing a 60% increase in productivity with RPA (Robotic Process Automation).
Increase in Productivity.
Illustration representing a 70% accuracy rate achieved with RPA (Robotic Process Automation).
Increase in Accuracy/Quality.
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Operations cost savings.


Illustration depicting a 50% reduction in claim denials with RPA (Robotic Process Automation).
Decrease in Claim Denial Rates.
Illustration representing a 30% decrease in a particular process or metric with the help of RPA (Robotic Process Automation).
Decrease in Regulatory Compliance Issues

Payer integrated Insurance eligibility verification system

eligibility verification system

Patient eligibility errors impact various areas of the payment integrity landscape. Identifying patient coverage before their visit or at the point of service is crucial to reduce operational and frontend bottlenecks. We secure payments for your healthcare organization through our patient eligibility verification system. Our insurance eligibility services are scalable and just the right solution for inpatient and outpatient services.

  • Making informed healthcare decisions

    Expedite processes

    Our smart automation simplifies, modernizes and quickens workflows. Our software interfaces securely and seamlessly with your EHR system.

  • Healthcare revenue audit report

    Predictive analytics

    User-friendly dashboards and advanced predictive analytics give you a bird’s eye view of eligibility processes enabling stronger decision making.

  • Effective budgeting and forecasting in healthcare


    Powerful API provides customized interface with your EHR.

Fasten your Patient eligibility and benefits verification process with RPA bots

  • Connected with more than 1500 payers across the country.
  • Bots are able to perform a wide range of searches if the patient information is limited.
  • Creating batch audits for hospitals and health systems with 100s of patient volume a day.
  • Faster eligibility checks within 5 seconds of request.
  • Includes TPAs, IPAs and other liability eligibility verification.
  • Cost friendly and lesser staff utilization for this process by utilizing RPA.
  • Verifying patients' eligibility and benefits is a complex repetitive process which is performed almost 365 days a year. Getting accurate information automatically using RPA Bots will reduce tension in your front office.


Delivering 100s of eligibility checks a day! Talk to us to know more.

We have 150 certified RPA resources experienced in the platforms below

White paper for RCM Best Practices
Anesthesiology practice case study
Orthopedic case study
Denial management whitepaper

We understand your concern for security and compliance

The RPA clinical data management in your system is 100%HIPAA compliant and is integrated into our RPA systems protocols to ensure your virtual work force remains as secure and compliant as your human one.

Get a 99.9% uptime guarantee, SOC 2 Type 2, ISO 9001, ISO/IEC 27001, and Veracode Verified


Automated Insurance Discovery for self-pay patients typically ends that 10% are eligible for primary and/or secondary insurance coverage, including Medicare and Medicaid.

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Discover other insurance:

Bots are able to directly pull secondary insurance coverage information. Other coverages such as HMO plans are detected automatically.

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Speciality specific information:

Increased repetitive task productivity compared to the manual workforce. Industry-standard quality when compared to HFMA or MGMA data.

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Continuous operations sustenance:

Targets your speciality and provides benefits and limitations. Detects non covered services listed under the patients plan.

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Other liability:

Other liabilities including IPAs and TPAs are processed automatically. Auto liability and no fault insurance carries including Workman's compensation eligibility automatically selected by the bots.

eClinicalWorks Revenue Cycle Management using Robotic Process Automation

Crystal clear charges and RPA assisted entry process for high accuracy

  • State of the art Optical Recognition Technology (OCR)
  • Best of Natural Language Processing(NLP)
  • State of the art Machine learning
  • Inbuilt NCCI and coding classifications
  • Interoperability between applications
  • Supports both providers and charge entry staff
  • Incorrect capturing of charges and entry of those incorrect charges can cost upto $2000 per patient. Robotic process automation (RPA) charge capture and entry reduces the rate of incorrect data.

Easy, less hassle and proven RPA solutions for higher patient volume health systems, surgical groups and clinics.

  • Less manual workforce required to register new patients and schedule existing patients appointment data.
  • Allows data to be forwarded to the front office records and doctors device to have better patient engagement.
  • Bots can navigate across multiple facilities and respective scheduling applications they use.
  • RPA bots can act as a patient support and guide them through the registration or scheduling process.
  • Increases productivity by 100%
  • Significantly reduces cost and increased patient volume simultaneously.

Delivering EOB/EOP Electronification with RPA payment posting.

  • State of the art optical recognition technology
  • Best of breed multiple OCR engines
  • State of the art Machine learning
  • Semi-structured form classification
  • AWS services (SQS, S3, etc...)
  • Elastic search (history-based validations)

Leveraging advanced RPA coding technology to produce the most efficient and accurate solution for identifying, documenting, and coding.

  • Supports both ACA Commercial and Medicare Advantage lines services and procedures.
  • Includes both CMS-HCC for Part C and RxHCC for Part D.
  • Configurable 2-stage ICD Parser that looks for all types of medical condition presences ranging from abbreviations to combination.
  • Latest updates from CMS included in the bots RAF databases , including complete ICD-9 and ICD-10 code list.
  • OCR that identifies content from medical records and charts, converting it into XML schemas and enabling which produces results in low TAT.
  • Cost reduction compared with hiring multiple AAPC certified coders.

Upgrade your denial and appeal management team to tackle your claim denial challenges.

  • Denial and Appeal RPA provides process and workflow improved denial management protocols in identifying the root cause of denials and appealing underpaid and denied claims.
  • RPA bots analyze ERAs and apply rules to detect suspected payments and denials in the appropriate team or automated work queues.
  • Reduces manual consolidation of your denial reports when it comes to detecting aging, priorities with dollar values and payers.
  • RPA bots build KPI using data added by HFMA MAP Key provides quantitative management where data is measured and used to drive improvement decisions.
  • RPA bots protocols can be defined to guide each step in the denial/appeals process, eliminate missed appeal deadlines, generate email notifications, and facilitate communication across the hospital or medical group.
  • Cost reduction compared with hiring multiple denial management staff for creating paper work and generating reports for consolidation.

How do we uncomplicate eligibility and
benefits verification using RPA?

Bulk batch reports eligibility and benefits verification for 1000s of patients at a time.
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Export verified data to the preferred billing system.
Illustration depicting high efficiency and performance achieved through RPA (Robotic Process Automation) in healthcare revenue management.
Higher rates of productivity.
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Lower percentages of human errors

Found insurance for 4,649 self-pay patients in a 3-hospital, 245-bed system in Northern Georgia for 12-months gained $3,473,407 in revenue at 60% less than other online eligibility platforms.

EHRs we work with

At BillingParadise we know the features and workarounds of your EHR system. All our RCM tools are integrated with the system you use.

Frequently Asked Questions

  • 1.What is Robotic process automation?

  • 2.Is RPA expensive?

  • 3.Can robotic process automation be implemented in all RCM operations?

  • 4.Which revenue cycle process would most benefit from robotic process automation?

  • 5.Does RPA avoid missing data denials in RCM processes?

Why BillingParadise

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EHR Software
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Million claims
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Growth Per month

You can bank on us because we are certified by...

We understand that implementation of RPA might be different from each and every practice and their EHR to get comfortable with the RPA we are providing our client half a month trial program where clients can operate these RPA bots and get the workflow setup they need. This allows you to identify the key tasks in which RPA can function and the rest 10-20% can be done by a manual workforce

Act now to obtain this offer.
Talk to our RPA experts to learn more.