How Cloud Maven, Inc Automated Provider Referral Management and Medical Document Processing

Our client, a transformative healthcare company, specializes in non-pneumatic sequential compression garments for venous and lymphatic care in the legs and arms. Operating on a high-volume document workflow, the business depends upon insurance approvals and medical necessity documentation from referring physicians. Every day, referring providers send patient records, diagnostic information, and authorization requests via faxes that must reach the right department quickly.

The organization's back office handles a critical function. The speed at which they process these documents has a direct impact on both patient care timelines and provider satisfaction. Any delays in turning medical paperwork result in bottlenecks in the entire system, causing frustration among all parties involved.

Most of the team’s time is spent managing and handling incoming faxes. The staff members have to first download files, identify the document type, manually enter data, tag each record with relevant patient information, and upload everything to the system. Processing one fax alone requires 28 minutes of employee labor. On average, the team receives 160 faxes per business day.

The workload distribution was uneven. Incoming documents sit in queues waiting to be processed by staff. Many providers call and ask if a particular document has been received. There is also much confusion regarding the status of the documents, how many successfully received, which ones failed, and what happened to missing files. Also the staff members downloaded files containing sensitive patient health information to their personal devices, which create compliance exposure.

Cloud Maven, Inc implemented its Fax Hub and Document Insight solutions, combining Salesforce fax integration with intelligent document processing to automatically identify document types, assign patient IDs, and capture provider details from incoming faxes. Data gets extracted from specific Salesforce records and fields that are linked to them.

The solution handles large documents up to 100 pages. Should any issues arise during transmission, users receive real-time notifications regarding the problem. Providers and patients receive email or notification on the status of their fax and next steps. Since all the processing occurs within Salesforce, there is no need for staff members to download anything on personal devices.

The automated fax platform and intelligent document parsing have transformed how the company handles incoming documents. Previously, processing these types of documents was a multi-person effort that took an entire workday. Today, with automation in place, they are able to accomplish this task in minutes.

• Reduced FTE workforce from 11 down to 4 which equates to annual cost savings of approximately $420,000
• Processing time dropped from 1 to 2 days to the same day for at least 95% of faxes
• Both provider and patient inquiries regarding document delivery decreased by 80%
• Document classification or tagging error rates nearly disappeared
• View or track both daily volume of incoming faxes and transmission failures
• Almost all documents remain within Salesforce, protecting patient privacy and ensuring HIPAA compliance