ExdionEVA: Eligibility & Benefits Verification

Eligibility and Benefits Verification Automation

ExdionEVA eligibility verification process automation uses AI to improve patient collections and staff productivity plus enhance the claims management processes and decrease denials.

Call (469) 277-8184 to learn more about our AI led insurance eligibility verification process in medical billing.

ExdionEVA for Smarter Eligibility Verification

About Client

Chief Administration office (CAO) of a major hospital located on the east coast was reviewing areas to arrest revenue losses and improve customer experience. One major challenge the hospital faced was that the front desk reps had no ways to ascertain patient eligibility at the time of admission. Without complete and up to date information the hospital carried a risk of revenue losses, potential litigation suites and customer experience. Hospital expected patients to pay for services upfront or prior subscribers an insurance plan to fulfill their financial responsibility. Accurate patient registration improves claims management processes and he was keen on exploring specialized partners who could help the hospital address this issue.

Solution

Like a blessing, sales director of Exdion Systems, a healthcare tech company sought an appointment to discuss Bots that could address service provider woes. The meetings turned out to a blessing. Exdion demonstrated EVA, a smart AI led BOT that exactly addressed the pain in patient eligibility verification process. Exdion EVA was implemented in a week and at one hospital staff and patients were able to look at insurance plans, eligibility and plan for any payments upfront, if required. ExdionEVA not only improved patient collections, but it also enhanced claims management processes. Eligibility-based claim denials decreased by 100%. Front desk staff productivity improved as EVA saved about 33 hours a month of manual verification. Front office staff could take on more important role and contribute to the revenue generation activities. Revenue cycle management (RCM) improved and customers waiting time reduced and overall patient experience of admission process saw a huge jump.

Benefits

Using EVA, the hospital could implement smart patient financial assistance programs wherever required. Hospitals introduced new financial assistance plans: a three-month plan directly with the hospital where the payments are made in parts over three month and an extended payment plan offered by a third party where payments could be extended to 12 months. Moving forward, the hospital intends to expand its online payment options to needy patients. With ExdionEVA staff engagement with patients has become positive, payments have become more transparent, and claims management very effective. CAO is happy that he could achieve all this at low cost, without replacing any staff and with strong impact on bottom line.