Top 10 Automation Use Cases for Mid-Market Healthcare Providers

Following are ten of the most impactful process automation use cases for mid-sized healthcare providers. 

1. Insurance Eligibility Verification – Automates insurance checks by retrieving and validating patient coverage details from payer systems, reducing claim denials and front-desk workload. 
2. Prior Authorization Management – Uses bots to gather clinical data and submit prior authorization requests to payers, accelerating approvals and reducing care delays. 
3. Patient Scheduling and Appointment Reminders – Automates appointment reminders and rescheduling tasks to reduce no-shows and optimize clinic schedules. 
4. Patient Registration and Data Entry – Streamlines patient intake by digitizing forms and auto-entering data into EHRs, improving accuracy and speeding up check-in. 
5. Billing and Claims Submission – Automates coding, claim generation, and submission workflows to reduce errors, speed up reimbursements, and lower billing costs. 
6. Denials Management and Appeals – Uses automation to detect, track, and resolve denied claims efficiently, improving revenue recovery and reducing manual effort. 
7. Regulatory Compliance and Reporting – Automates data aggregation and formatting for required reports, ensuring timely, accurate compliance with reduced staff burden. 
8. Referral Coordination and Patient Follow-Up – Creates a closed-loop referral process by automating referral tracking, appointment confirmations, and follow-ups. 
9. Provider Credentialing and Onboarding – Accelerates provider credentialing and payer enrollment by automating document collection, form filling, and status tracking. 
10. Prescription Management and Refill Processing – Automates prescription refill workflows by checking eligibility and submitting approvals, reducing delays and freeing up clinical staff.