FEATURED CASE STUDY
Home Care Operations, Automated at Scale
CLIENT
A national home care and healthcare services organization managing high-volume authorization, billing, reimbursement, supply reorder, and operational workflows across multiple business functions.
The organization required automation-led process transformation to reduce manual effort, improve operational throughput, lower denial rates, and generate measurable cost savings across revenue-impacting healthcare workflows.
CHALLENGES
The client operated several manual and semi-manual processes across authorization, billing validation, supply reorders, asset recovery, call recording archival, and internal operational workflows.
These processes created administrative bottlenecks, increased labor dependency, slowed transaction handling, and limited scalability across high-volume healthcare operations.
The client needed to:
- Automate sales order authorization workflows
- Reduce denial rates across a large revenue base
- Improve billing edit validation and support ticket workflows
- Reduce manual effort in Medicaid license comparison and payer validation processes
- Improve supply reorder workflows for eligible patients
- Automate identification of patients requiring asset recovery follow-up
- Create business-user access to monitor and run automation processes
- Improve archival, storage, and processing of millions of call recordings
- Strengthen deployment processes, coding standards, and application architecture practices
- Increase operational capacity without adding proportional headcount
Without automation and process modernization, the organization faced continued manual bottlenecks, avoidable labor costs, slower processing cycles, higher cost of delay, and missed opportunities to improve revenue protection and operational efficiency.
SOLUTIONS
Technossus delivered a portfolio of automation, process improvement, cloud, and platform modernization initiatives to improve operational performance and reduce cost across the client’s home care workflows.
These initiatives helped the client improve automation coverage across authorization, billing, supply reorder, asset recovery, data processing, cloud storage, and deployment workflows.
The new automation ecosystem gave business users better access to operational tools, reduced dependence on manual processing, and improved the reliability and scalability of high-volume healthcare operations.
The solution included:
Care authorization automation to streamline the sales order authorization process
Billing edit validation support to reduce manual ticket handling and improve accuracy
Medicaid license comparison automation to support billing validation workflows
Medicare secondary payer validation to prevent avoidable revenue leakage
A redesigned internal automation toolbox for business users to monitor, manage, and run automation processes
Bulk update and administrator capabilities to manage security across created APIs
PCS LTC automation to automatically fax supply reorder forms when patients were due or eligible for supplies
Batch automation for same or similar rental and routine durable medical equipment workflows
Asset recovery automation to identify patients with unpaid bills and trigger recovery processes programmatically
Migration of more than 5.5 million call recordings from a contact center platform to Azure Blob Cold Storage
Use of cloud resources and auto-scaling to process millions of records efficiently
Data warehouse integration and reporting enablement across operational datasets
Automation of deployment processes using CI/CD pipelines and Azure DevOps
Process improvements aligned to best practices, coding standards, secure architecture, and maintainable application design
Adoption of Azure Key Vault into coding standards
API management discovery and evaluation using APIM and MuleSoft
IMPACT
