Preauthorizations Intake

The preauthorization forms intake use case accelerator automates paper Prior Authorization intake forms from email, STP or shared drive, classifies the documents, extracts required information.

What is a UiPath accelerator?

UiPath use case accelerators are automation frameworks which are custom-built for specific use cases. These frameworks use best practices and pre-built components which can be modified, expanded, and customized based on the needs of each specific use case and customer, enabling faster time to value for your automation programs.

Note: Accelerators are not plug-and-play solutions. The accelerator package codebase contains reusable components that interact with specific systems (e.g., Coupa, etc.). These components are meant to be used as a starting point / example for how such components should be built in an actual implementation.

Preauthorization Forms Intake Use Case Accelerator

Preauthorization, also called prior authorization, represents a critical exchange of information between healthcare providers and payers. Payers will make the decision if the requested care service, treatment plan, prescription drug or durable medical equipment is medically necessary. Mistakes in information and documentation submitted by providers and slow decisions on the part of payers due to manual processes can lead to delayed care and higher costs.

Automating preauthorization forms intake assists preauthorization intake analysts with faster and more accurate processing of intake queue items:

• Multichannel intake functionality to connect and access the request forms from sources like email and shared folders.
• Provides automated classification of faxes to respective categories.
• Uses UiPath Document Understanding (DU) for information extraction, bringing human in the loop when required through UiPath Action Center.
• Validates data with embedded data format validation rules.

The preauthorization forms intake use case accelerator package provides a set of customizable resources you can use to quickly automate and optimize your processes. The accelerator comes pre-loaded with the ability to process forms like:

• 2021 Mental Health Service Request Form
• 2021 Prior Authorization Request Form
• Arizona Medicaid Prior Prescription Authorization Form
• California General Request Prior Rx Authorization Form
• Kentucky Medicaid Prior Authorization Form
• Member consent form
• Michigan Medicaid Prior Authorization Form
• NEfaxform immunomodulators asthma
• Nevada Medicaid Prior Authorization Form
• North Carolina Medicaid Prior Authorization Form
• Ohio Medicaid Prior Authorization Form
• Tennessee Medicaid Prior Authorization Form
• Texas Medicaid Prior Authorization Form
• Cigna Prior Authorization Form
• Sunshine Health Prior Authorization Form

One UiPath customer reports the following benefits from automating Pre-Auth forms intake:

• ~45% faster processing of each day’s incoming appeals requests
• Workload reduced by more than 3 hours per FTE
• Faster throughput and assignment of cases has reduced TAT failures
• Reduced compliance risk
• Up to 35,000 hours saved per year
• More them $650,000 saved per year

Follow these four easy steps:

1. Download the accelerator package.
2. Integrate it into your workflow.
3. Define the intake source.
4. Configure UiPath Orchestrator

The code in this accelerator package processes a pre-authorization form in this progression:

1. Email or simple dispatcher
2. Document understanding*
3. Performer

• New deployment capabilities using UiPath Solutions Management
• Get paper preauthorization forms from email, SFTP or Share drive
• Classify Document
• Extract information & validate business rules
• Exception handling & routing