Case Study

Conversational AI and Intelligent Automation Reduce Payer Denials, Improve Employee Efficiency

Conversational AI and Intelligent Automation Reduce Payer Denials, Improve Employee Efficiency

Guidehouse partnered with Automation Anywhere to help a major health system reduce insurance claim denials and improve efficiency through Process Discovery and Intelligent Automation. Over two weeks, more than 1 million activities were analyzed, revealing inefficiencies in revenue cycle operations, such as eligibility verification errors causing \$44M in annual denials. Automation and conversational AI streamlined tasks like claim corrections and prior authorizations, saving 2,000+ rework hours. Seven new automation use cases were identified, and future plans include expanding optimization across HR, supply chain, and payroll functions.

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