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Insurance Eligibility & Verification Automation for Front-End RCM

Insurance Eligibility & Verification Automation for Front-End RCM

โ€ข <1 Minute Eligibility Checks
โ€ข 70โ€“80% Fewer Insurance-Related Denials
โ€ข 1โ€“1.5 Hours Saved Daily per Staff Member

Overview

A regional ambulatory network saw rising insurance-related denials due to outdated or inaccurate patient coverage information. Manual eligibility checks required multiple payer-portal logins, slowing registration and triggering downstream rework. GeBBS implemented an RPA-enabled Eligibility & Verification Automation solution that accelerated coverage checks, improved accuracy, and strengthened front-end financial clearance.

Opportunities & Challenges

The manual verification process caused:
โ€ข 5โ€“10 minutes per patient spent on eligibility lookups
โ€ข Frequent denials tied to inactive plans or benefit changes
โ€ข Long patient wait times at check-in
โ€ข Inconsistent documentation across sites
โ€ข High administrative burden on front-desk teams

Solution

Automated Eligibility Verification & Coverage Documentation
GeBBS deployed RPA bots to:
โ€ข Run automated eligibility checks through payer portals and APIs
โ€ข Update active coverage details and benefits directly in the EHR
โ€ข Flag mismatches requiring staff review (inactive plans, PCP changes, deductibles)
โ€ข Document verification results instantly to support financial clearance

Outcomes

โ€ข Eligibility Time: Reduced from 5โ€“10 minutes to <1 minute
โ€ข Denials: 70โ€“80% reduction in insurance-related denials
โ€ข Registration Speed: Up to 5 minutes saved per patient
โ€ข Staff Efficiency: 1โ€“1.5 hours saved daily per registrar
โ€ข Accuracy: Standardized coverage data across all clinics

Key Takeaways

โ€ข Automated eligibility checks prevent denials at the source.
โ€ข Faster verification improves patient experience and throughput.
โ€ข RPA eliminates repetitive portal work and standardizes processes.

Conclusion

With eligibility automation, GeBBS improved front-end accuracy, reduced preventable denials, and enhanced patient accessโ€”supporting smoother operations and stronger revenue performance.

Client Testimonial

โ€œWeโ€™ve cut verification time to seconds. Our denial rates dropped dramatically, and registration finally keeps up with patient demand.โ€
โ€” Manager, Patient Registration

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