Case Study
Overview
A major hospital network partnered with Innoira to automate real-time insurance eligibility verification across multiple payer systems, eliminating the manual phone calls and portal checks that consumed staff hours daily and caused delays in patient care.
BUSINESS CHALLENGES
- Staff spent 4-6 hours daily on manual insurance verification calls and portal lookups
- Verification delays caused patient frustration and delayed treatment initiation
- High claim denial rates due to eligibility errors discovered post-service
- Multiple payer portals with different interfaces required extensive training
SOLUTION IMPLEMENTED
- Deployed RPA bots to automatically query eligibility across 40+ payer portals in real-time
- Integrated verification results directly into the EHR and patient registration systems
- Automated alerts for coverage gaps, prior authorization requirements, and benefit limitations
- Created standardized eligibility reports for front-desk staff with actionable insights
Impact Delivered
95% Faster
Verification Time
From 15 minutes to under 45 seconds per patient
-40%
Denial Rate
Reduction in eligibility-related claim denials
25 hrs/day
Staff Hours Saved
Redirected to patient care activities
-60%
Patient Wait Time
Reduced check-in and registration delays