Automated reimbursement

Processing medical practitioners’ invoices with Picklist

Some Austrian health insurance providers were facing a steadily increasing paper load due to private medical practitioners’ invoices. Cloudflight and ITSV GmbH implemented a solution that automates the processing of these invoices. Now employees only have to check and confirm the results.

Anton Bayer, Industry Focus Leader Public Sector at Cloudflight

Anton Bayer
Industry Focus
Leader Public Sector

Get in touch

0%

more submissions per year can now be handled by the same staff

>0%

time savings per case

0

cases per day currently processed by this system

Automated document processing

Picklist, our Artificial Intelligence-based solution, enables automated processing of documents. This significantly reduces errors, saves time and costs. Watch the video to see how our customers can save up to 20.000 working days per year!

Challenge

Until now, the clerks of the Austrian health insurance providers had to process the private medical practitioners’ reimbursements manually in order to extract the relevant information such as practitioner, patient, treatment and costs. In the process, cases are increasing by 8% annually. This has led to an ever-increasing backlog in processing for many insurance companies.

Idea

The clerks should be supported by automatically extracting and validating the information from the invoices. Manual entry is then eliminated, only the verification of the information needs to be done. This should be made possible by:

  • Machine text recognition in combination with content recognition through computer vision, natural language understanding and machine learning
  • Creation of a highly scalable system for processing large amounts of data

Solution

Picklist, a scalable web-based system, processes the scans of the invoices and presents the results to the clerk in an intuitive view. All he has to do is review the extracted data and correct it if necessary. The system has the following features:

  • Complete integration into the existing software landscape
  • Acceptance of scanned or photographed fee invoices
  • Document pre-processing
  • OCR (Optical Character Recognition)
  • Document classification (fee invoice, payment document, medical assignment, etc.)
  • Entity extraction (patient, insured person, attending practitioner, services billed, diagnoses made, costs)
  • Assignment of entities to each other (date to service, name to insurance number)
  • Plausibility check
  • Recoding of services in free text to the service catalogs of the carriers
  • Recoding of remedies to the official reimbursement code of remedies
  • Recoding of diagnoses to the official ICD-10 catalog
  • Matching of services with diagnoses
  • Recognition and reading of handwritten IBANs
  • Recognition of handwritten annotations and differentiation of signatures
  • Recognition of a balancing note
  • Intuitive UI

This is how our modular, automated system works

The clerks are relieved of all steps that can be automated, as the individual components such as text recognition, entity recognition or post-processing communicate with each other in a decoupled manner via queues. The system is both scalable and fault-tolerant. The result of the processing is visible in a modern web interface and the data can still be corrected for special cases before the costs can be reimbursed.

The capabilities of Machine Learning 

The system was taught to find the required content in differently structured medical invoices in order to process them automatically. The machine learning part of the application was continually tested against a wide variety of metrics during development. This ensured that the recognition of future, never-before-seen documents would also work reliably.

Digital archiving as an add-on

In addition to digitalization of the reimbursement process, digital archiving of documents has been introduced. These now only need to be kept digitally. A positive side effect was that employees were enabled to work securely from home for several months during the Covid 19 lockdown starting in March 2020.

What are you looking for?

  • Do you want to use a web-based system to digitize your processes and achieve greater efficiency?
  • Do you process a lot of documents and need to extract certain information?
  • Do you receive many free-text orders every day?
  • Let us talk. We will be happy to support you in your individual use-case.
Anton Bayer, Industry Focus Leader Public Sector at Cloudflight

Anton Bayer

Industry Focus Leader Public Sector
Anton Bayer has been managing the Vienna office for more than 8 years. As part of the management team and head of the public sector at Cloudflight, he is the first point of contact for both employees and our customers.

Get in touch

Cloudflight
Cloudflight realized this project thanks to experts from all fields, from requirements engineers to scrum masters, software architects, DevOps and software engineers to data scientists.

ITSV
ITSV GmbH is our implementation partner in this project. As an innovative technology company, they manage and coordinate the IT activities of the Austrian social security system.

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