The Appeal Architects

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The Appeal Architects

Use Case Description

This solution leverages the power of Robotic Process Automation (RPA) and Generative AI to automate the creation of clinical summaries and streamline claims and appeals management. Designed initially for healthcare, where denial resolution involves analyzing over 700 pages of complex medical records, the solution efficiently extracts, organizes, and summarizes data across multiple critical sections such as History, Consultation, Vital Signs, Radiology, and Lab Findings. By integrating NLP and automation tools, the process significantly reduces manual effort, improves accuracy, and accelerates appeal preparation.

The solution is scalable beyond healthcare, with applications in legal, financial services, government, and other industries requiring large-scale documentation processing and appeals handling. It empowers stakeholders to make data-driven decisions, reduce costs, and enhance operational efficiency, offering a transformative approach to complex document management workflows.

AS-IS WORKFLOW, TO-BE WORKFLOW

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Other information about the use case

Industry categories for this use case: Finance, Healthcare Pharma, HR, Legal, Marketing Sales, Insurance

Skill level required: Intermediate

UiPath Products that were used: UiPath Studio, UiPath Action Center, UiPath Document Understanding, UiPath Orchestrator

Other applications that were used: Gen AI, Python

Other resources: -

What is the top ROI driver for this use case?: Improve customer experience