• <1 Minute Eligibility Checks
• 70–80% Fewer Insurance-Related Denials
• 1–1.5 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A regional ambulatory network saw rising insurance-related denials due to outdated or inaccurate patient coverage information.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:
• 5–10 minutes per patient spent on eligibility lookups
• Frequent denials tied to inactive plans or benefit changes
• Long patient wait times at check-in
• Inconsistent documentation across sites
• High administrative burden on front-desk teams
Solution
Automated Eligibility Verification & Coverage Documentation
GeBBS deployed RPA bots to:
• Run automated eligibility checks through payer portals and APIs
• Update active coverage details and benefits directly in the EHR
• Flag mismatches requiring staff review (inactive plans, PCP changes, deductibles)
• Document verification results instantly to support financial clearance
Outcomes
• Eligibility Time: Reduced from 5–10 minutes to <1 minute
• Denials: 70–80% reduction in insurance-related denials
• Registration Speed: Up to 5 minutes saved per patient
• Staff Efficiency: 1–1.5 hours saved daily per registrar
• Accuracy: Standardized coverage data across all clinics
Key Takeaways
• Automated eligibility checks prevent denials at the source.
• Faster verification improves patient experience and throughput.
• RPA eliminates repetitive portal work and standardizes processes.
Conclusion
With eligibility automation, GeBBS improved front-end accuracy, reduced preventable denials, and enhanced patient access—supporting smoother operations and stronger revenue performance.
Client Testimonial
“We’ve cut verification time to seconds. Our denial rates dropped dramatically, and registration finally keeps up with patient demand.”
— Manager, Patient Registration
