HealthCare Automation or Automation in American HealthCare
All workflows of HealthCare have seen Automation. AI, ML, NLP, RPA are tools & capabilities to bring automation into HealthCare.
Again as we have summarized before, American HealthCare is divided into 4 broad buckets of Ps:
· P1 – Payers
· P2 – Providers
· P3 – Pharma
· P4 – Platform
Interestingly, all 4 Ps have seen Automation. For P4 (COTS or Build), the Automation Algo is to achieve CI-CD, NoCode-LowCode, DevOps, DecSecOps & Infra Automation (for Hosting & Security).
The largest impact of Automation has been found in the Claims space.
Again, we must focus on 3 broad types of claims i.e.
· Professional Claims
· Facility Claims
· Self-Funded Claims*
IMP – All Claims are paid by Payers except this one as Cash-Rich Corporate / Entity (mostly Govt)
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