Client Overview
A large multi-specialty hospital in the U.S. serving over 250,000 patients annually faced growing operational inefficiencies. Administrative teams were burdened with repetitive
manual tasks such as claim submissions, payment posting, appointment scheduling, and insurance eligibility checks.
CapMinds partnered with Robocorp, a leading open-source RPA platform, to deliver a
robust automation solution designed specifically for healthcare workflows.
The Challenge
The hospital’s revenue cycle and front-office teams struggled with:
- High manual workload In claim creation, eligibility verification, and EOB posting.
- Frequent errors: Due to human data entry, leading to delayed payments.
- Rising operational costs: With staff spending 40% of their time on repetitive tasks.
- Lack of real-time: Visibility into claim status and appointment confirmations.
The hospital leadership wanted to reduce administrative overhead, accelerate cash flow,
and free up staff to focus on patient care.
Our Solution: Intelligent RPA with Robocorp
CapMinds designed and deployed a bot-driven automation framework powered by
Robocorp. The solution eliminated manual work across both RCM and patient operations:
Highlights:
Eligibility Verification Bot:Automated insurance eligibility checks through payer portals and APIs.
ERA & Payment Posting Bot: Parsed electronic remittance advice (835) files and posted payments into the EMR with zero manual entry.
Denial Management Bot: Flagged and routed denied claims to billing teams with pre-filled appeal templates.
Claim Creation & Submission Bot:Generated and submitted 837 claims, validating data accuracy before transmission.
Scheduling Assistant Bot: Confirmed patient appointments via SMS/email and updated cancellations in real-time.
Technical Execution
| Component | Implementation Details |
|---|---|
| RPA Platform | Robocorp (Python-based RPA, cloud orchestration) |
| EMR/RCM Integration | HL7, REST APIs, and secure database connectors |
| Automation Scope | Eligibility → Claims → ERA → Denials → Scheduling |
| Bot Use Cases | Eligibility, 837/835 EDI, payment posting, denial workflow |
| Infrastructure | Secure hybrid cloud deployment with audit logging and analytics |
Results & Impact
The project exceeded all expectations and delivered a dynamic, interactive platform that has since been featured in multiple UiPath sales and partner engagements.
Quantifiable Success:
Reduction in manual data entry tasks across billing and scheduling.
Accuracy in payment posting and eligibility verification.
Increase in staff productivity, allowing redeployment to patient-facing
roles.
Faster claim turnaround, with average processing reduced from 14 days to
5 days.
Annual savings in administrative costs.
Strategic Outcomes:
- The hospital gained a scalable automation framework adaptable to future use
cases. - Improved cash flow predictability and reduced claim denials.
- Enhanced patient satisfaction due to faster appointment confirmations and billing
transparency.
Why CapMinds?
CapMinds brought unique value through:
Deep RCM expertise
And healthcare interoperability knowledge.
Robocorp partnership
Enabling cost-effective, Python-driven RPA solutions.
Rapid deployment
— bots were live within 8 weeks, delivering ROI from Day 1.
Compliance-first design
Ensuring HIPAA and HITRUST alignment.
What’s Next
Following the initial success, CapMinds and the hospital are expanding automation into:
Prior authorization workflows.
Automated patient refund processing.
AI-driven denial prediction integrated with RPA bots.
Scaling bots across additional specialties and satellite clinics.
Ready to bring intelligent automation to your RCM workflows?
Let’s talk about how we can transform your healthcare operations.
Executive Summary
CapMinds, in partnership with Robocorp, delivered a transformative RPA solution that empowered a leading hospital to reduce manual workloads, accelerate revenue cycles, and improve patient care delivery. With intelligent automation at scale, healthcare leaders can achieve both operational efficiency and financial resilience.
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