Overview
One of Omega Healthcare’s largest clients — with 18,100+ employees serving more than 4,300 hospitals and physician practices — needed to improve its denial management processes, starting with appeals.
Manual, complex workflows and cross-system data collection were delaying appeal generation and driving up the risk of errors.
What They Needed
- A standardized, automated appeals process to reduce manual burden
- Reliable, automated data collection from disparate systems
- Faster, more efficient generation and dispatch of appeal letters
- A scalable approach to improve provider satisfaction
Omega Healthcare’s Solution
- Data-collection BOTs to fetch patient information from various systems (including clinical documentation)
- Automated population of appeal letters using standardized data
- Automated submission of appeal requests
- One-click electronic dispatch of appeal letters
Results
Through its partnership with Omega Healthcare, the client:
- Achieved 60% faster turnaround times on appeals
- Improved accuracy — with no human intervention
- Significantly increased their denial overturn success rate
- Streamlined dispatch and enabled better workforce allocation to value-added tasks
- Improved provider satisfaction
- Maintained 100% HIPAA compliance throughout the process
