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What is intelligent document processing healthcare?

February 8, 2024 | Healthcare, Intelligent Document Processing

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Amidst evolving technology, the healthcare insurance sector is witnessing a pivotal transformation with the advent of Intelligent Document Processing – a significant innovation that has revolutionized data analysis and management. This concept, characterized by its ability to understand, extract, and interpret data from varied document types efficiently and accurately, directly answers the industry’s urgent need for swift data handling and documentation.

 

The shift toward automated document processing in healthcare

 

Intelligent document processing for healthcare is signaling a future where manual and time-consuming document processing is replaced by automated, accurate, and expedited alternatives. Imagine a world where every historical patient record, invoice, medical test, doctor’s order, and claim are expedited and seamlessly integrated into the operational flow.

Industry leaders are actively exploring innovative approaches to transform operations and scale automation in the healthcare insurance sector, with a specific focus on diverse document types derived from unstructured information. Health insurance document automation remains a business imperative if insurance companies are going to meet their digital transformation goals.

Additionally, intelligent document processing plays a crucial role in capturing institutional knowledge by codifying processes, ensuring continuity and efficiency even amidst employee turnover. Furthermore, automated models provided by intelligent document processing ensure regulatory compliance by consistently executing processes correctly and capturing necessary data. Ultimately, intelligent document processing delivers transformational change, empowering health insurance companies to compete effectively in today’s dynamic market landscape, regardless of their size or tenure in the industry

Related content: How to automate long-term healthcare invoice processing

 

Why healthcare is a fit for Intelligent Document Processing

 

Healthcare insurance providers process millions of important patient documents annually, many of which require manual review to assess what they say accurately and any associated context. This kind of labor-intensive process naturally takes time, which means it involves a significant financial investment by the provider.

Part of the problem is that a large percentage of health insurance documents are unstructured or semi-structured. That puts them out of reach of solutions that rely on templates as well as health insurance robotic process automation (RPA) tools. By leveraging the power of AI to automate and streamline operations, healthcare insurers can ensure accurate, cost-effective, and time-efficient decision-making.

Intelligent document processing can deliver big savings. Automating even part of the process delivers significant productivity gains. If you can succeed in training a model to reliably recognize 80%, 85% or 90% of the values you care about, that translates into a dramatic increase in process capacity – meaning fewer people to do the same work. Now you’ve freed up employees to do other, more strategic work, or set yourself up for lots of growth without increasing headcount.

Related content: Indico Data named a leader in Everest Group’s intelligent document processing (IDP) PEAK Matrix® 2023

 

The future of Intelligent Document Processing in healthcare

 

The introduction of intelligent document processing in healthcare insurance marks a pivotal moment in the industry’s digital transformation. By automating and streamlining tedious and time-consuming paperwork, healthcare insurers can focus on reducing process cycle times and compete more effectively, no matter if they’re a startup, insurtech, or industry stalwart. Investing in such cutting-edge technologies as intelligent document processing is no longer a luxury but a vital necessity, allowing healthcare insurance organizations to extract maximum advantages in terms of efficiency and accuracy.

 

Intelligent Document Processing healthcare use cases

 

Health insurance document automation solutions take advantage of artificial intelligence (AI) to improve productivity in numerous processes involving unstructured content, including the following.

Health insurance claims automation
Processing an individual claim can be a painstaking process. Say a hospital files a claim for services it renders, such as an MRI. Before paying the claim, the health insurer must go through the patient’s electronic health record (EHR) file, which may contain hundreds of pages, to find the doctor’s order for the MRI. The claim may also involve the actual MRI image, which would be far out of reach for an RPA tool to handle, but no problem for the Indico Unstructured Data Platform.

Long-term care invoices
Dealing with invoices for patients in long-term care can be especially demanding for health insurance companies because the stakes are high and there are numerous values to extract. Beyond the basics of name and dates of care, those details include hours, rates, and line items for each required service. Traditionally, agents must read the invoices and manually input relevant values into a downstream processing system, such as K2. Healthcare document processing models, combined with an RPA tool for data entry, can automate 85% or more of the process. In some instances, an IDP model can enable straight-through processing, such as for invoices pre-processed by a third-party provider like AssureCare.

Patient record processing
An IDP platform can also help health insurers deal with patient records. IDP models can be trained to ingest paper documents, images and digital records from hospital EHR systems. They can automate the process of sorting, identifying and matching paper documents, including faxed documents, to a patient’s EHR.

Claim denial documentation
When a health insurer denies a claim, it’s likely the matter will come up again from either the provider, patient, or both. When it does, it behooves the insurer to quickly assemble its supporting evidence for why the claim was denied. Intelligent document processing models can help in that effort, by finding relevant documents, extracting supporting evidence on why the claim was denied, and assembling it to expedite a response to the provider or patient.

Ingesting claims documents

Claims documents tend to arrive in large bundles containing numerous discreet documents that pertain to different claims. Employees spend hours going through these bundles and determining where each individual document belongs. A sound healthcare document processing model would be able to automate the process of sorting and categorizing the individual documents, and keeping associated documents together for further processing.

Automate document workflow
Intelligent document processing can help health insurance companies classify all sorts of documents, including patient and provider correspondence, clinical documentation and various kinds of reports. Healthcare document automation models can be trained to extract key data from each type of document, such as a patient date of birth, data of service, address, provider name, patient name, member ID numbers and more.

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