Automation of the process of examining and requesting medical care benefit cost using robotic process automation

Abstract

Medical service industry has been developed based on Electronic Medical Records (EMR), Electronic Document Interchange (EDI), and Hospital Information System (HIS) in the e-health era. One of the key tasks undertaken by the hospital’s administration department, the request for medical care benefits, even though it is a digitized system, involves manual work by workers, such as comparing medical records. To minimize inefficiencies when applying for medical care benefits, the hospital bills the insurance claims review agency after self-examination. However, when the amount of data to be screened is large, there is a problem that increases the time and error rate of the self-examination process. This study applied RPA (Robotic Process Automation) to the self-examination process, which is the first step in the entire process of the request for medical care benefits. RPA automates the task of dealing with regular and structured data, reducing time and human error and maximizing work efficiency through the relocation of corresponding personnel. The automation of the self-examination process applying RPA reduces the time and error rate required to process work and demonstrates the applicability of RPA in the medical industry. © 2021, ICIC International. All rights reserved.