Automation Engine

Through a unique combination of business rules, automation and integration, the IPD Automation Engine transforms previously manual processes into automated tasks. With millions of manually intensive transactions received annually, the ability to avoid assigning all of them to internal staff for resolution provides significant cost savings.

Based on rules, eligible transactions are placed within work queues for automated handling. Claims that cannot finish adjudication because it is a possible duplicate or the member number suffix is missing are examples of these types of exceptions. The Business Rules Engine (BRE) assesses the exception conditions, made available to it by the IPD Work Distribution Module. These rules, fully configurable within user-friendly tables to support dynamic changes, evaluate each transaction and determine the appropriate course of action.

The second major component of the IPD Automation Engine is a series of automation agents, or 'robots', that perform pre-defined tasks for the items residing within the work queues. Applying the rules housed within the Business Rules Engine, these agents automatically perform a variety of tasks that would otherwise require human intervention. Through Ultera's integration framework, transactions are passed to administrative systems, completing the work process without human involvement.