Provider Sanction Validation

Bot validates and fetches sanction details for provider based on multiple search criteria from OIG DB which is utilized by business processes to make decisions.

Top Benefits

  • Improves claim processing by efficient searching mechanism
  • Reduce manual cost
  • reduce human errors

Tasks

  • Download OIG database
  • Get Provider Details
  • macro to copy result set in an output sheet
Business process requirements for processes such as Provider Credentialing, Out of Network Provider verification for Medical Claims, Referring Provider updates need to validate Sanction Details for Provider based on multiple search criteria. This accelerator shall help perform this activity efficiently without having to navigate multiple screens. This activity downloads the latest downloadable List of Excluded Individuals/Entities database provided by the OIG office. This activity searches the provider details from the source data file received from the previous activity, as per the provided search criteria. It will fetch the matching list of providers as the output result. Business processes can utilize these results to make business decisions regarding sanction.

Setup process

Install

Download the Bot and follow the instructions to install it in your AAE Control Room.

Configure

Use the Bot in a bot, configure keys and other credentials the Bot will need (see the ReadMe for details.)

Run

That's it - now the Bot is ready to get going!

Requirements and Inputs

  • Microsoft Excel

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