AI Capability Delivers 200% ROI In 6 Months
Regional multi provider healthcare authority (with over 1000 diverse providers) became aware of significant ballooning of composite procurement costs and duplicate payments for the same service to different providers. They required a solution to accurately track services procured and delivered across providers, and then accurately identify service billing attribution and identify duplicate costs and potential fraud.
BML designed and delivered an AI based solution to automatically map healthcare service delivered across all providers to procured services, and appropriate billing attribution. This was enabled at the core through a standardised data model, fully pseudonymised patient data, integration with providers’ clinical and billing systems, cyber security, AI governance, and automation to action billing adjustments and clinical service record corrections.
Fraud Prevention
- Service delivery transparency and accurate provider billing attribution enabled automated fraud identification.
Procurement Savings
- Reduced service delivery costs from poor procurement and duplicate billing by £10million with in 6 months.
Automatic Corrections
Foundation for further acquisitions and accelerated post-transaction integration.