Industry:Healthcare
Region:North America
Client:CareSource
CareSource is delivering better healthcare with intelligent automation
90%
of invoices processed automatically
50%
reduction in manual labor
98.5%
auto-adjudication rate for claims, up from 92%
Client Overview
"Health Care with Heart" signifies CareSource's approach to offering quality healthcare. For over 30 years, they've prioritized members, providing healthcare to over two million people and employing 4,500+ staff across the United States. CareSource was looking to improve their healthcare document processing to serve their members better. They aimed to automate this process to reduce manual work, enhance efficiency and accuracy, and allow for reinvestment in member care, company growth, and employee development.
Streamlining healthcare, one process at a time
CareSource has always been member-first and always will be. Despite its growth, it’s never lost sight of the difference it can make in members’ lives by helping improve their health and well-being. This focus drove CareSource to rethink how it was processing large volumes of critical healthcare documents. For example, it sought to eliminate struggles its Claim, Utilization Management, and Clinical Management (C/UM/CM) team had in reviewing a wide range of documents from vendors, providers, and members within its stated service level agreement.
The way we want to take our company forward is to take advantage of AI in everything that we do as a company. We look at automation as an opportunity to not only reduce costs and manual work, but just as importantly, to improve the quality of the work. It translates into the money that we save that we can invest in the care of our members, the growth of the company, and the growth of our employees.
Outcomes:
Improved claim processing efficiency: CareSource enhanced its claims processing, reducing manual intervention for faster turnaround times and improved service delivery
Enhanced prior authorization and invoice processing: They optimized the handling of prior authorization, faxes, and invoices, mitigating delays and ensuring consistent service delivery
Transformed clinical operations: AI and robots ™revolutionized various clinical processes, enhancing accuracy and overall operational efficiency
Additional resources:
Like CareSource, meet other the 2024 UiPath AI25 Award winners, showcasing the power of AI and automation across industries. Discover how these leading companies are leveraging the UiPath Platform™ to drive innovation, improve efficiency, and redefine success.
Related case studies
