Solutions for Providers

Work smarter, not harder.

Prior authorizations can include many voices and layers, but the administrative burden doesn’t have to be so heavy. Trade the fax-phone-portal hustle for a real-time intelligence platform that connects directly to your payers, so decisions—and patient care—are free to move faster.

Rhyme makes it easy for providers to move from transactions to deeper, more meaningful interactions. Our platform funnels the right questions to the right people at the right time.

Solutions for Payers

The wall between payers and providers? It’s gone now.

Providing thoughtful, quality care for your members is hard to do without meaningful provider interactions. Talking over a wall is an antiquated method, so we tore the wall down. The replacement? An intelligent, collaborative, integrated network that makes life easier for everyone.

Providers, Payers

Industries: Healthcare, RCM

Provider Systems: Epic

Payer Portals: eviCore, United Healthcare, Magellan

Challenge

A large healthcare provider needed to ramp up their automation strategy to offset labor instability and attrition. Currently the staff manually have to go out to payer portals, submit requests and check statuses of Prior Authorizations, sometimes multiple times. Through Task Mining AI (Artificial Intelligence) analysis, it was determined that staff were spending about 30 – 40% of their time submitting requests and checking the status for 19,000 prior authorizations per month.

Prior Authorization Requests: 3 bots processing prior authorization requests in 3 separate portals (EviCore, Magellan and UHC).

• EviCore: 923 transactions per month
• Magellan: 595 transactions per month
• UHC: 7,063 transactions per month

Prior Authorization Statusing: 3 bots processing prior authorization statuses in 3 separate portals (EviCore, Magellan and UHC).

• EviCore: 5,536 transactions per month
• Magellan: 3,572 transactions per month
• UHC: 986 transactions per month

Solution:

RPA bots are a much more accurate and effective solution to verify the status of patient health authorizations, RPA bots can repeatedly check requests under review for status changes and updates.

CampTek Software was engaged because of its healthcare and Epic experience. Through task mining, AI models were created, and results were reported back to the customer with enormous success. The next phase of design and build all occurred in a brief time. The bot now in production includes business rules, exception handling and daily reporting functionality. It is also supported by CampTek as an ongoing managed service solution for the provider.

The Bot is now saving 2,696 FTE (full-time employees) hours per month or 32,352 hours (about 3 and a half years) per year. The FTE capacity gain is 17 FTEs (full-time employees), and the ROI (Return on Investment) is $1,085,000 per year.

Any healthcare provider