RPA, AI help speed review of Medicare claims -- GCN

Employees and contractors at the Centers of Medicare and Medicaid Services spend countless hours every year reviewing thousands of medical records to ensure the accuracy of Medicare Advantage payments. An automated intake tool is working to change that. Using emerging technologies such as robotic process automation, optical character recognition, machine learning and artificial intelligence, KPMG's Intake Process Automation Tool ingests records as they are submitted and identifies potential problems according to set parameters, submission rules and coding guidance. Specifically, RPA orchestrates the steps of the intake process, OCR digitizes the scanned document and then AI and machine learning are applied to understand the document and extract the information necessary to validate the information. Intake PA stands to save CMS time and money, said Payam Mousavi, KPMG's lead director for intelligent automation for governments and the technical lead for the CMS project.