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RPA and AI Services

Bringing Artificial Intelligence to RPA
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Artificial Intelligence (AI) and Robotic Process Automation (RPA) are transforming how healthcare organizations improve performance and reduce costs. At RISARC, our AI/RPA-powered automation solutions increase staff productivity, enhance accuracy and boost both customer and patient satisfaction while lowering operational expenses.

Our intelligent software Digi-staff reads documentation, analyzing language and visuals and executing complex workflows.

Partner with RISARC to automate your revenue cycle and achieve higher KPI metrics.

Prior Authorization / Pre Certification

RISARC's Front-End Module automates the pre-certification and pre-authorization process, verifies patient eligibility and identifies the correct insurance payer before service delivery. By eliminating manual verification and pre-auth delays, our AI-powered Digi-staff ensure data accuracy and compliance at the start of the revenue cycle—resulting in cleaner claims, faster reimbursement and measurable improvements in key performance indicators.

Demonstrated Benefits

  • Speed: Human staff complete ~3 authorizations per hour vs. Digi-staff at 50 per hour - improving front-end throughput and KPIs productivity benchmarks.
  • Digi-staff automates eligibility and payer validation before claim submission, reducing eligibility denial rate to under 5% KPI benchmark.
  • Digi-staff automatically follows up for determinations KPI benchmark. Digi-staff automatically follows up for determinations that are not immediate and enter determination data into the client's EMR system.
  • Digi-staff notifies physicians for peer-to-peer review opportunities, accelerating pre-cert completion and improving authorization turnaround KPIs.
  • Fewer claim rejections and rework, achieving clean claim rates above 98%.