Scott & White’s current processes, plus a potential influx of new applicants from the passage of the Affordable Care Act (ACA), meant significant time would be spent manually entering and changing data in their core system for things like pay class set-up, establishing new provider networks and more.
In a process that took as many as four weeks to perform, Scott & White’s team would create networks by manually copying and pasting rate, service, and other information from a similar plan into the new ones. New pay classes were created the same way, often occupying as much as 45 minutes of a worker’s time per job.
The RPA solution
Already a Nintex RPA customer, Scott & White automated the task of performing pay class set-up, provider network creation, and much more. Nintex RPA works in the presentation layer (the user interface) of most core systems by punching keys and moving data just like a person would, but much more accurately. In so doing, Nintex RPA takes much of the time-consuming manual work off SWHP employees’ hands and frees them to handle other projects.
Nintex RPA now needs just one week to establish new networks in a simple copy-and-paste process – a 75 percent reduction in time. Establishing new pay classes, a chore that had taken up to 45 minutes before Nintex RPA, now takes just five minutes when done automatically. This is all done with total accuracy.
Nintex RPA handles claims, too. Those affected by retroactive pricing changes are now re-run automatically, regardless of whether the claim is in-process or completed. The software automatically credits the physician’s account and issues a check for the fee difference rather than occupy a full-time employee. “There’s rarely a day where there is not some Nintex RPA script running here,” said Gengo. “We’re a small shop for a plan of our size. One of the reasons we’re able to be so productive with a small team, and even scale our operation quickly without adding headcount, is because we have an automated solution.”