Downloading records from the hospital system

This BOT is majorly used for the appeals process. Using the patient demographics and the date of service this BOT retrieves the Medical records from the hospital systems.

Medical Record Mapping

All the claims that require appealing will be pulled by the BOT for which cover letters will be auto-generated, following which the retrieved medical records will be attached.

Faxing Documents to the payer and attorney

The prepared appeals will be automatically faxed by the BOT to the respective payer. It will also update the successful transmission of the same in the billing system.

Claim status check and workflow toll update

This BOT will automatically pull the claim status from the payer portal and update the same in the billing system. Wherever applicable this BOT will also take the next step toward any denials.

Litigated claim status and workflow toll update

We have a separate BOT that pulls the status of litigated claims from the judicial website.

Download rejection report from clearing house & take action

Claims that are rejected at the clearing house are fetched by this BOT and wherever applicable the BOT will automatically send the corrected claim.

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