Insurance Verification BPM

Case Study:
Health Insurance Verification for Home Care Equipment

workflow software case study | JobRouter | Business Process Management Case Studies | Digital Process Automation for healthcare Insurance

workflow software USE CASE: ORDER PROCESSING
INDUSTRY: HEALTHCARE

A US supplier of home medical products used JobRouter workflow software to convert their manual and paper-based insurance verification process to a streamlined online process - and speed order processing and increase sales as a result.

CHALLENGE:

The company provides a full line of home medical equipment including products such as walkers, wheelchairs, adjustable beds, C-PAP machines and oxygen concentrators and nebulizers. Before orders can be processed, the customer's medical insurance coverage for each product ordered must be verified. While some products are almost universally covered by all insurance carriers, other products may not be covered. A single order might involve as few as one or as many as six different insurance carrier verifications as well as communications with the customer and the Ordering Physician.

The existing manual process was handled by the multiple sales and customer services teams located in 5 different branch offices. Hand written notes and offline communications were not being tracked consistently and there was no visibility into verification or order status.

Almost every school faces the challenge of managing a mountain of paper with inefficient manual procedures. JobRouter gives K-12 Schools the power to easily and quickly convert any paper-based or manual procedure into a user-friendly and effective automated process. The significant time, costs and resources that are recovered can be re-dedicated to better serve students and parents.

SOLUTION: JobRouter Used to streamline Order Processing

workflow software case study | Healthcare Business Process workflow automation

SOLUTION: 

JobRouter workflow software was used to convert the insurance verification process into an automated online process that now provides real-time visibility into order and verification status. Intelligent forms help the customer service team to collect all required details from the different categories of insurance carriers. All related internal and external communications are recorded and attached to the process. When an order includes multiple products, the order can be split as verifications are confirmed. This allows the company to process and deliver parts of the order as items are approved for coverage.

Almost every school faces the challenge of managing a mountain of paper with inefficient manual procedures. JobRouter gives K-12 Schools the power to easily and quickly convert any paper-based or manual procedure into a user-friendly and effective automated process. The significant time, costs and resources that are recovered can be re-dedicated to better serve students and parents.

Results & benefits

  • ​100% online process is optimized, faster
  • Consistent process across all locations
  • Notifications and escalations keep process moving
  • Teams able to support and fill-in for each other
  • Able to ship products to customers sooner
  • ​Real-time visibility of order status
  • Able to process more sales with same staff
  • One button end-of-month reporting
  • Powerful custom reporting
  • Built-in audit trails