MEDICAL CLAIMS AUTOMATION MANAGER
MCAM
THE CHALLENGE
State and local agencies are overwhelmed, faced with antiquated systems, and ever-changing coding requirements.
As a result, few claims are being processed quickly or efficiently.
In partnership with Blue Prism and Red Hat, we’ve created Medical Claims Automation Manager; a fully integrated, secure, and automated claims processing solution that helps patients and providers execute claims faster and more efficiently.
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MEDICAL CLAIMS AUTOMATION MANAGER (MCAM)
THE SOLUTION
The Medical Claims Automation Manager empowers a Blue Prism digital workforce to:
- Flag improperly coded COVID-19 claims from providers
- Verify ICD10 codes are correct and related to services performed
- Verify patient enrollment status and benefits availability
- Verify patient/provider enrollment completion in MMIS
- Re-route incorrectly coded COVID-19 claims to the appropriate API
- Scan forms and submit patient claims for reimbursement