ACI’s YesBot Improves Eligibility Verification for a Leading Healthcare Giant

The client is a highly diversified Fortune 500 company into healthcare and well-being business and has access to healthcare through networks which includes 1.2 million physicians and other health care professionals. It has approximately 6,500 hospitals covering various other facilities.

Key Challenges

The customer was using a manual verification system, which was cumbersome, leading to a couple of challenges that include:

Lack of collaboration with Medic-aid agencies

Increased inbound requests from Medic-aid agencies

Complex evaluation & authentication

Manual hassles

To address these challenges and enable a faster verification process, the client explored a couple of automation options for its policy eligibility checks. It ultimately partnered with ACI Infotech to deploy YesBot, a proprietary Robotic Process Automation (RPA) solution built to streamline and strengthen eligibility validation.

Key Highlights

Intelligent Content Evaluation: Interprets and processes data accurately to support reliable eligibility decisions.

Automated Data Interpretation: Enables the system to analyze information seamlessly without manual intervention.

Accurate Reporting & Analysis: Automatically transfers data across systems, eliminating human errors and ensuring high data accuracy.

Rapid Verification: Converts and scans multiple data sources in real time, allowing eligibility confirmation and customer updates within seconds.

With successful implementation of ACI’s YesBot solution, the client enjoyed the following benefits:

50% reduction in resource cost for the same process

100% accuracy in data verification and analysis

60-90% increase in verification efficiency and response

50% cut in workload, enabling the client to achieve better, accurate and quick results