Home Care Operations, Automated at Scale

CLIENT

A national home care and healthcare services organization managing high-volume authorization, billing, reimbursement, supply reorder, and operational workflows across multiple business functions.

The organization required automation-led process transformation to reduce manual effort, improve operational throughput, lower denial rates, and generate measurable cost savings across revenue-impacting healthcare workflows.

CHALLENGES

The client operated several manual and semi-manual processes across authorization, billing validation, supply reorders, asset recovery, call recording archival, and internal operational workflows.

These processes created administrative bottlenecks, increased labor dependency, slowed transaction handling, and limited scalability across high-volume healthcare operations.

The client needed to:

Automate sales order authorization workflows
Reduce denial rates across a large revenue base
Improve billing edit validation and support ticket workflows
Reduce manual effort in Medicaid license comparison and payer validation processes
Improve supply reorder workflows for eligible patients
Automate identification of patients requiring asset recovery follow-up
Create business-user access to monitor and run automation processes
Improve archival, storage, and processing of millions of call recordings
Strengthen deployment processes, coding standards, and application architecture practices
Increase operational capacity without adding proportional headcount

Without automation and process modernization, the organization faced continued manual bottlenecks, avoidable labor costs, slower processing cycles, higher cost of delay, and missed opportunities to improve revenue protection and operational efficiency.

SOLUTIONS

Technossus delivered a portfolio of automation, process improvement, cloud, and platform modernization initiatives to improve operational performance and reduce cost across the client’s home care workflows.

These initiatives helped the client improve automation coverage across authorization, billing, supply reorder, asset recovery, data processing, cloud storage, and deployment workflows.

The new automation ecosystem gave business users better access to operational tools, reduced dependence on manual processing, and improved the reliability and scalability of high-volume healthcare operations.

The solution included:

Care authorization automation to streamline the sales order authorization process

Billing edit validation support to reduce manual ticket handling and improve accuracy

Medicaid license comparison automation to support billing validation workflows

Medicare secondary payer validation to prevent avoidable revenue leakage

A redesigned internal automation toolbox for business users to monitor, manage, and run automation processes

Bulk update and administrator capabilities to manage security across created APIs

PCS LTC automation to automatically fax supply reorder forms when patients were due or eligible for supplies

Batch automation for same or similar rental and routine durable medical equipment workflows

Asset recovery automation to identify patients with unpaid bills and trigger recovery processes programmatically

Migration of more than 5.5 million call recordings from a contact center platform to Azure Blob Cold Storage

Use of cloud resources and auto-scaling to process millions of records efficiently

Data warehouse integration and reporting enablement across operational datasets

Automation of deployment processes using CI/CD pipelines and Azure DevOps

Process improvements aligned to best practices, coding standards, secure architecture, and maintainable application design

Adoption of Azure Key Vault into coding standards

API management discovery and evaluation using APIM and MuleSoft

IMPACT

The automation-led transformation improved labor efficiency, process performance, cost control, and operational scalability across multiple healthcare business functions.

By moving from manual, fragmented operational workflows to scalable automation-enabled processes, the client reduced costs, improved performance, strengthened revenue protection, and created a more efficient foundation for high-volume home care operations.

Business Impact

Delivered more than $1.5 million in annual labor cost savings
Reduced denials from 11% to 9% across $4 billion in revenue
Automated the entire sales order authorization process
Processed approximately 1,000 sales orders through authorization automation
Generated 50% monthly FTE cost savings in authorization workflows
Delivered $200,000 in annual savings through billing edit validation support
Prevented more than $70,000 per month through Medicare secondary payer validation
Increased existing billing edit stability capacity by more than 50%
Generated approximately $60,000 annually through PCS LTC automation across labor savings and revenue generation
Successfully processed an initial pilot run of 3,000 patients for rental and routine DME automation
Created more than $100,000 in projected savings from batch same or similar rental and routine DME automation
Generated approximately $50,000 annually through asset recovery automation
Migrated more than 5.5 million call recordings to Azure Blob Cold Storage
Created more than $120,000 per year in cost avoidance through cloud archival optimization
Improved automation and labor cost efficiency
Improved performance across operational workflows
Reduced cost of delay through faster processing and fewer manual bottlenecks
Strengthened process improvement, deployment automation, and engineering standards

30%Estimated reduction in manual coordination

2xFaster visibility into priority workstreams

90 daysRoadmap-ready delivery foundation

1Shared operating model for teams

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Home Care Operations, Automated at Scale

The solution included:

Business Impact

Have a similar challenge to solve?

Home Care Operations, Automated at Scale

The solution included:

Business Impact

Have a similar challenge to solve?