Automated Document Processing System for Healthcare Referral Management

The organization relies heavily on manual processing of high-volume referral faxes and scanned medical documents, leading to bottlenecks, late responses to urgent cases, inefficient resource allocation, and increased risk of missing time-sensitive referrals. They employ dedicated staff for sorting and qualifying referrals, which is labor-intensive and limits operational scalability.

A growing healthcare organization specializing in diagnostic and treatment services for sleep disorders, managing high volumes of referral documents and medical records.

• Implement an automation system to sort and classify incoming referral documents, including faxes and scanned images.
• Enhance processing capacity from manual sorting of approximately 150 referrals per day to handle over 570 documents automatically daily.
• Reduce manual effort by automating the closure of routine, non-actionable documents, with a target of 25% closure without human intervention.
• Improve response times to urgent referrals by detecting and alerting relevant staff immediately upon receipt.
• Reallocate staff previously engaged in manual document sorting to higher-value tasks, aiming for at least a 12% increase in overall referral processing productivity.
• Achieve annual labor cost savings of at least $40,000 by automating repetitive tasks.

• Scheduled bot to periodically access a web-based inbound referral document database.
• Integration of OCR engine to extract machine-readable text from scanned images and faxes.
• Automated classification of documents into predefined types based on extracted text.
• Automatic closure of routine authorization documents requiring no further action.
• Real-time detection of urgent referral documents and immediate email alerts to responsible staff.
• Reassignment of complex or urgent documents to manual processing teams.
• Daily summary report email detailing sorted documents and current status.

• Inbound referral document database system
• Email system for alerts and notifications
• Case management or referral tracking platform for manual handoffs

• System scalability to process over 570 documents daily without degradation
• High accuracy in OCR text extraction and document classification
• Security measures to ensure HIPAA compliance and protect patient data
• Reliable performance with scheduled runs seamlessly across work hours
• Maintainability for future updates and integration expansions

The automation solution is anticipated to process over 570 referral documents daily, eliminating backlog and significantly reducing processing time. It will enable the reallocation of staff to high-value tasks, resulting in at least $40,000 in annual labor cost savings, a 12% boost in referral processing productivity, and improved handling of urgent cases through immediate alerting, ultimately enhancing service quality and operational efficiency.