Problem Statement:

  1.  To look for the best doctor/hospital near by the user is a tidy task .
    
  2.  To book an appointment with the doctor and finding for the doctor’s availability.
    
  3.  Insured is not aware of the policy like how much it would cost him for the particular treatment.
    
  4.  Patients are not aware of the hospital process thus facing difficulty during the admission and discharge time.
    
  5.  There has always been communication gap between the three parties i.e. the patient, hospital and the insurance company.
    
  6.  For every query asked by insurance company hospital takes a lot of time to reply back to their queries resulting in the increase of hospital billing.
    
  7.  Due to delay in getting discharge the critical condition patients are not able to get the bed/room in the hospital.
    

Solution:

  1. With the help of UIpath patients/end user will be able to find the best doctors/hospitals near them on the basis of our ranking algorithm which has been applied after the refined search from google itself.

  2. In just one click end user/patient will be able to book the appointment of the doctor. An algorithm runs in the background which will fetch the doctor’s availability and book the appointment in just a single click away and an appointment summary will be provided to the end user/patient’s Email Id and to the provider.

  3. If doctor wants the patient to get admitted in the hospital then doctor will feed the data for the disease then an automatic mail will be sent to the patient about “the estimated cost for that treatment and what is the co-pay amount and deductible amount”. With the set of rules defined in Ui path an algorithm with fetch the patient’s detail on the basis of policy number and will sent an email to insurance company and the patient. So before getting admitted in the hospital insurance company and the patient will be agreed mutually to get the treatment smooth.

  4. The communication gap between the three parties can be avoided, since before getting admitted in the hospital both of the party i.e. insurer and the insured are agreed mutually and claim will be approved in the early stage itself.

How we developed it :

We have created two automations to accomplish the task.

First automation: ProviderSearch will be used by the patient to search effectively for a doctor/hospital for the disease/illness he/she is suffering from and present near him/her.The automation uses google search to initially list the top providers present near the patient and then applies a ranking algorithm based on certain other parameters which are generally not considered like time to reach the provider (considering the traffic conditions).

After the filtered list is completed an email to the patient will be sent with the attached file having the same list and also a direct link for booking the appointment.

· Once form is submitted an Email is sent to patient and provider with the details of the appointment.

. Second automation: CostEstimation will be present at the provider site. automation comes into picture after the patient has been examined by the doctor and the patient need to go under some treatment .It is used to determine the cost estimated for the treatment by taking an average estimation from the past records for a similar case. It will then check if the disease/treatment is covered under the policy in which patient is covered.

If the treatment is covered under the insurance policy then what is the expected cost of the procedure and out of that what would be covered under and what amount would be patient liability.

The same will be conveyed to the patient and insurance provider through message and email.

Future development:

· Ranking Algorithm Improvement :

o More factors will be added to provide better results

o Data can be scrapped from multiple sites and compared

· Sentiments Analysis :

o From the reviews found online extract the keywords and do sentiment analysis giving more authenticity & better ranking.

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