SERVICE

Developed a flexible and dynamic Benefits Verification Salesforce tool to improve process efficiency

BV Wizard – A tool in Salesforce for the benefits verification process by analyzing the historical data and coming up with a dynamic questionnaire and contextual suggestions using AI/ML models.

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Reduction in end to end timeline for benefits verification process

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Excess BV per day processed by the user team and hence addressing more cases

“D Cube Analytics team helped us improve our efficiency tremendously. The team was collaborative, understood our problem well and results were exceptional.

We are now efficiently able to handle more cases per day.”

Objective

The Client was using Salesforce and Patient access call center-based processes to engage with Patients and understand their eligibility for the several patient support programs. This process has many manual touchpoints and consumes a lot of time, leading to verification backlogs and unclear visibility on the staffing needed to support these initiatives.

For reducing manual intervention and improve the performance efficiency of the BV process, we developed this fully automated and AI-driven tool in Salesforce.

Introduction

Analyzed the data repository maintained by the user group to identify the questionnaire for various coverage and payer groups. Integrated several business rules to dynamically bring up the questions based on each case.

Utilizing AI/ML models and historical data, we created contextual suggestions for each question. Automated the whole process to integrate with the existing Salesforce tool.

Solution

  1. Build the BV wizard module’s backend in cloud and frontend in Salesforce environment
  2. Collaborated and driven business rules discussions with the user group in finalizing the standardized business rules to be used in creating a dynamic questionnaire
  3. Expanded the scope to include AI/ML model that could power to provide contextual suggestions for each question
  4. Assistance keying in details from payer call along with payer details

Outcome

  1. Minimizes human error during verification and data entry
  2. Process efficiency due to availability of the dynamic questions and contextualized suggestions
  3. Availability of historical repository helps better planning of the payer call
  4. Automatic integrations save time and eliminates manual entry errors
  5. Cost savings on processing each BV

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