CUSTOM MEDICAL BILLING AUTOMATION
Medical Billing Review at Scale. Less Manual Work.
A large plaintiff law firm worked with Lexmata to streamline repetitive billing reviews across its Personal Injury Protection (PIP) claims. The result was a customized workflow that saved significant staff time and monthly costs.
Of encountered billing form variations handled automatically in this customized workflow.
THE CHALLENGE
15–30 Minutes. Claim After Claim.
A senior paralegal at a large plaintiff law firm recognized that Lexmata could identify medical billing codes. She wanted to know if that capability could help with a bigger problem: the amount of time her team spent reviewing medical bills.
The firm’s Personal Injury Protection (PIP) team included approximately 15–20 reviewers working through billing information across tens of thousands of injury claims.
For each claim, reviewers manually compiled and compared billing details, a process that typically took 15–30 minutes.
THE APPROACH
A Workflow Built Around the Team’s Needs.
Lexmata developed a custom process to identify medical billing codes, extract relevant information, export the data into an Excel spreadsheet, and total the appropriate columns for review.
The workflow also helped the team compare billing information against Medicare and Medicaid cost structures and examine differences between claims and payments.
Lexmata built the workflow around the firm’s existing process, taking on more of the repetitive work.
THE CUSTOM WORKFLOW
- 1Identify Billing Codes
- 2Organize Data in Excel
- 3Compare and Review
CONTINUOUS IMPROVEMENT
Refined as New Forms Appeared.
The initial workflow automatically handled approximately 85% of the billing form variations the team encountered.
As new formats appeared, Lexmata refined the process. Over time, that figure increased to approximately 98%, reducing the amount of repetitive work left for reviewers.
THE RESULTS
Less Manual Review. Lower Monthly Costs.
Instead of manually compiling and comparing billing information claim after claim, the team could work from organized data and focus on what needed attention.
What started as a question from a senior paralegal became a more efficient process for managing a high volume of billing reviews.
LET’S TALK
Have a Manual Review Process Worth Rethinking?
Tell us where your team is spending time compiling or comparing medical information. We’ll talk through how Lexmata works and whether a different approach could help.