Engage IQ™ is built to ensure the best response and outcomes at each stage of the patient journey. It is also designed to make the overall experience remarkable, by building trust with patients through consistency and personalization.

Engage IQ features the following:

• A digital front door delivers a retail-like experience for consumers to shop for services, compare prices and self-schedule
• Channel intelligence empowers patients to interact with providers in the channels they prefer and are most likely to respond to
• Operationalization of RevSpring’s proprietary propensity to pay models predict likely payment outcomes so providers can improve them—from the very beginning of the patient experience
• OmniChannel reminders ensures patients remember and prepare for appointments
• A digital intake experience pre-populates known information, and allows patients to input and correct personal data using innovative optical character recognition (OCR) for enhanced convenience, fewer handoffs, and essential accuracy
• A virtual waiting room lets patients check in from the car, from their living room, or anywhere, and co-pay or prepay using the device in their hand
• Automated care plans keep patients connected to their providers—with critical follow-up after a care episode
• A digital first approach to billing uses intelligence to determine patients most likely to engage digitally, while using printed communications strategically to increase response and control costs
• The use of empathy in the self-service and staff-assisted payment experience, leveraging intelligence to match payment options to the needs of the patient to increase yield and self-service convenience, and reduce staff burden.

The value of Engage IQ spans all types of provider organizations. Primary benefits include:

1. Increased yield and a predictable rate based on the provider’s own patient population and current performance
2. Self-service improvements to off-load busy staff
3. Cost savings, with a focus on not simply more engagement but precise engagement using print and digital channels
4. Administrative cost savings, with focus on front-end data quality, such as clean claims and patient intake accuracy, and more

These benefits apply to:

IDN/Health Systems, Physician Groups, Pharmacies and other Specialty Providers, including Urgent Care, Ambulance Services, ASCs, Orthopedics, Dermatology, Women’s Care, and more. 

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