Our Client here is a provider of in-home care services to elderly and disabled individuals. The company has been experiencing challenges with its billing reconciliation process. This has led to incorrect billing and delayed payment from insurance providers.

Problem

The current billing reconciliation process at Client’s firm involves manual tracking of patient care services. This is time-consuming and prone to errors. The manual nature of the process makes it difficult to accurately track patient care services and reconcile insurance payments.

Solution

To improve the billing reconciliation process, the client decided to implement an automated solution. This would streamline the process and reduce the risk of errors. The company chose to integrate its billing software with its electronic medical record (EMR) system, which would allow for real-time tracking of patient care services.

Implementation

The implementation of the new automated solution was a seamless process. The team integrated the billing software with the existing EMR system and made the necessary updates to ensure that the software automatically recorded all patient care services. The company also provided training to its employees to ensure that they were familiar with the new process and how to use the new system effectively.

The challenge

The client receives an intimidating number of invoices (close to 80) on a daily basis from its many vendors for the procurement of business tools and equipment. The hitch was the high FTE involvement in invoice reconciliation before processing vendor payments. Constant human intervention inevitably introduced errors, inefficiency, undue delays, and high costs to the process.

The nature of the process qualified it as an excellent candidate for automation. Our RPA team commissioned themselves to fine-tune the task and conducted a system audit. They also shortlisted the business implications of implementing RPA.The client grasped the big picture of the advantages, following which the team accomplished the job in 2 months.

Before RPA

• Vendors send invoices over emails. A dedicated resource identifies all unread emails from a particular vendor and downloads all unprocessed invoices.
• The macro-based Excel file exports the invoice details such as invoice number, amount, and date.
• The resource then logs into the FTP server to download the purchase orders for that vendor and loads the corresponding data in the same Excel file.
• The macro-based Excel file runs to compare the invoice line items and the purchase order line items to identify unmatched invoices and line items. Then it sends reconciled invoices to the accounting department for processing.
• The resource logs into the vendor management (VIM) tool to locate unmatched invoices. If they find any, they execute the process of data extraction and matching in the Excel file. If someone can’t find the invoices, they send an email to the vendor seeking more details of the invoice.

After RPA

RPA bots execute the same tasks in the same sequence while ensuring fewer errors and eliminating human intervention.

• Bots run at 9 am every morning, access the mailbox, and identify emails with invoice(s) as an attachment (by reading the subject line).
• Bots download invoices in an allocated folder and, using OCR capabilities, extract the invoice number, amount, and date to a macro-based Excel file. For invoices in any invalid format, bots convert them into a compatible format before extracting the data. In case of exceptions, the in-house team and the vendor get a notification.
• From the FTP server, bots copy the corresponding purchase order data to the same file.
• Someone runs the Excel-macro to spot unmatched invoices by comparing each invoice line item with those in the purchase order.
• Someone updates the status at every step in the FTE server and displays it under a live BPO dashboard to notify the user of the reconciliation process.Someone shares the list of reconciled invoices with the finance people to initiate the payment.
• One sends all matched invoices to the finance department and searches for unmatched ones in the VIM tool. One automatically sends an intimation to vendors asking for more details for invoices that they can’t find in the tool.
• For out of scope scenarios, concerned persons are notified.