Summary
A prominent healthcare organisation was struggling with inefficiency in processing patient claim authorisations and consolidating data across multiple systems. The manual workflow — retrieving data, verifying claims on healthcare portals, extracting details from PDFs and updating results — was slow and error-prone.
We implemented a UiPath solution automating the entire workflow from extraction through to database update. The automation achieved up to 80% reduction in manual effort, improved accuracy to 95%, and enabled continuous 24×7 operation.
The client
A large healthcare provider managing thousands of insurance claims monthly. The claims team handled authorisation verification for patient treatments covered under various insurance plans. Volume and case complexity meant the manual process produced delays, data inconsistency and compliance challenges.
The problem
Authorisation verification meant moving between four systems for every claim.
- 01Retrieve claim details from the internal SQL database
- 02Log into the healthcare portal for authorisation verification
- 03Download and review authorisation PDFs
- 04Extract and record key data in Excel spreadsheets
- 05Update validated information back into the database
What it was costing
- High manual dependency and long processing times
- Frequent data entry errors affecting claim accuracy
- Delayed claim resolution and slower reporting cycles
- Limited scalability during peak claim periods
- Compliance risk from inconsistent audit documentation
Objectives
Goals
- Reduce manual intervention and repetitive tasks
- Increase accuracy in data extraction and entry
- Ensure faster claim processing and reporting
- Enable 24×7 automated operation with minimal supervision
- Provide complete traceability through automated logs and audit reports
Success criteria
- 80% reduction in manual processing effort
- 95% improvement in data accuracy
- 60% decrease in turnaround time for claim validation
- 100% automated audit logging for compliance
What we built
A modular design with separate components for extraction, validation and update — so a change to the portal doesn't mean rebuilding the whole process.
Secure credential handling
Bot login and credentials managed through UiPath Orchestrator rather than stored in the workflow.
Automated PDF extraction
Authorisation PDFs downloaded and read using OCR and ML-based templates in Document Understanding.
Real-time reconciliation
Validation and reconciliation between the healthcare portal and the internal database as the process runs.
Exception handling and retries
Retry mechanisms built for process resilience against portal instability.
Automated audit logging
Complete traceability captured automatically for compliance reporting.
Delivery
5 weeks — process analysis — development — UAT — go-live
- Process analysis and feasibility
- PoC development
- Modular build across extraction, validation and update
- UAT with the claims team
- Go-live and phased expansion to all claim types
Challenges and how we handled them
Stakeholders
Results
| Measure | Before | After |
|---|---|---|
| Manual effort | 100% manual | 20% manual oversight |
| Accuracy | 75–80% | 95–98% |
| Processing time | 8–10 hours/day | 2–3 hours (automated) |
| Scalability | Limited | Easily scalable |
| Audit logging | Inconsistent | Automatic, every transaction |
Quantitative
- 80% reduction in manual workload
- 95% accuracy in claim data validation and entry
- 3× faster processing and reporting cycles
- 100% compliance-ready automated logs and reports
Qualitative
- Higher employee satisfaction through workload reduction
- Better insurer and patient experience from faster turnaround
- Strengthened audit and compliance controls through automated traceability
Business value delivered
Operational scalability
The framework absorbs high claim volumes without a matching increase in effort.
Compliance and governance
Automatic audit trails support transparency and adherence to healthcare data standards.
Cost efficiency
Significant reduction in FTE hours and resource dependency on a critical process.