Intelligent Automation for Patient

Data Extraction, Review, and Claim

Submissions for a Leader in
Specialty Healthcare

Organization
The customer is a leading specialty care management company with an
Processes automated
exclusive focus on cancer and cardiac care. The company focuses on Patient data extraction
transformation of the delivery of oncology and cardiovascular care by Patient data review
aligning healthcare payers and specialty providers with smart technology, Patient claim submission
clinical data analytics, and deep clinical expertise.
Industry
Healthcare
Challenges
A desire to improve patient experience drove this client to review the
potential to transform its back-office operations. Disconnected systems
required a ‘Swivel-Chair’ solution in order to manage patient data. Manual management of
unstructured data was significantly
More than ten employees were required to manually extract and
delaying our claim submission
review patients’ data
process. Nividous Bots automated
Documents received by fax or scan were highly unstructured,
the data extraction, review, and
unclear and sometimes illegible
claims submission tasks, enabling a
Due to diverse document structures, no fixed extraction template
reduction in a process handling time
existed
by 70%. We are glad that our staff
Documents received in bundled PDFs, causing delays in processing
can now focus on more productive
and client communication
tasks.
High probability of errors, omission of required data and associated
claims rejection
COO
Delayed payments due to a backlog of claims filing A Leader in Specialty Healthcare

Solution
Within two weeks, the Nividous team developed and deployed Nividous Bots
For more information on how healthcare
with cognitive capabilities to automate end-to-end data extraction, review,
professionals use Nividous platform visit:
and claim submission process.
https://nividous.com/case-studies#healthcare

Benefits

80% 70% 65% 45%

Reduction in Reduction in Increase in Decrease in

manual work process handling time productivity operational cost

www.nividous.com contactus@nividous.com +91 (22) 2605 4583

Automated Data Extraction
Scheduled Bots retrieve PDF documents from central location
Bots intelligently detect and split patient data from bundled PDF using advanced Computer
Vision and Machine Learning capabilities
Bots automatically identify, extract and update required data from documents utilizing cognitive capabilities

Intuitive, Assisted Data Review and Claim Submission

Nividous / My Tasks

Task: Review Patient Details Status: Active

Task Form Attachments Diagram Comments

Patient Details 2 /7 Data Fields

Patient First name

MIKE

05/03/2019 11:29AM FAX 0002/0007 Patient Last name

ABC XYZ CLINIC, LLP - 1000 15th ABC 5, ABC XYZ 12345-67890
REDMIKE HESTER (id #12345678, dob: 02/11/1940
HESTER

Patient REDMIKE HESTER (79yo,M) ID: Patient Middle name

Name 12345678 Appt. Date/Time 05/01/2019 09:10AM

DOB 02/11/1940 Service Dept. Urology RED

Bundled Documents
Provider XYZ
Insurance Med Primary: HUMANA - 0000 Lorem Ipsum is simply dummy text-000000
Insurance #: A12345678 Patient DOB
Employer Name: RETIRED

on Patients Records
Pre-scription: DSTPSDIR - Member is eligible
Chies Complaint
02/11/1940
post-op, check, prostate cancer
Patient’s Care Team Patient Height (Inches)
Urologist:
Primary Care Provider: Lorem Ipsum is simply dummy text of the printing and typesetting industry. 69
Optometrist: Lorem Ipsum is simply dummy text of the printing.
Endocrinologist: Lorem Ipsum is simply dummy text of the printing and typesetting industry. Patient Weight (Ibs)

183.6
Section 1.10.32 Lorem Ipsum is simply dummy text of the printing and typesetting industry. 12345,
ph(123) 123-4567, Fax (123-4567
Lorem Ipsum is simply dummy text of the printing and typesetting industry.

Intuitive Interface for Human Review

Advisor / CV Template Manager Intuitive configuration for extracting

CV Template Details Add/Remove form Fields
structured/unstructured data using advanced
Computer Vision and Machine Learning concepts
Template Type

Structured

Advanced Bot-Human orchestration, enabled by

Patient First Name
Template Name

Nividous platform, created human review tasks for

Patient Details Template Patient Last Name

extracted details
Template Description
Patient Middle Name
Patient details template to extract the patient information

Patient DOB
User review tasks include intuitive user interface for
Upload File

Choose File masked Oncology fax.pdf

Patient Height
check and correct
Patient Weight Upon completion of human review, Nividous Bots
Patient Id submit claims to payer websites
Next

Empowerment through Accuracy and Data Visibility

Nividous Control Center dashboard provides visual statistics including accuracy by document type, and
accuracy by insurance provider
Auto-generated reports can be customized and allow drill-down from dashboard into detailed report view

Patients by service type Patients Accuracy

110

88
Patients by service type
66

Cardiogy
44

22
Oncology

William Jackson Lewis William Anna

Other
Not Extracted(%) Partial(%) Correct(%)

www.nividous.com contactus@nividous.com +91 (22) 2605 4583