Leveraging Azure Machine Learning to improve billing accuracy and consistency

Business Context

The ability to provide accurate invoicing for patient stays in hospital is a significant challenge for the healthcare industry. Inaccurate billing often results in unpaid claims from medical aids or patient dissatisfaction and a poor patient experience.

Challenge

Improve the billing process through insights and predictive analytics

• High number of touch points involved in every case that is billed resulted in slow billing, billing errors and write-offs from stale claims not actioned timeously.

Solution

Azure machine learning solution that validates a patient’s bill in near real-time

• A custom-built rules engine to enable business to prevent known billing issues before a patient is discharged or final billed.
• PowerBI dashboard to support operationalisation and adoption of the solution.