Complaint Documentation Reimagined

Efficiently addressing patient or member complaints is crucial for organizations, requiring thorough investigation and diligence. However, the time-consuming nature of manual review and documentation processes can lead to poor customer experiences. Automation within the process can facilitate timely resolutions.

The Challenge

A patient transportation provider was dedicating 7,500 hours annually to verifying customer complaints. This extensive time commitment diverted resources from core services, delayed complaint resolutions, and hindered timely service improvements.

The Solution

Amitech, a Naviant Company, developed an automation solution for the patient transportation company complaint verification process utilizing an unattended bot to streamline operations. The bot accesses the QMS Quality Queue to acquire complaints, searches Outlook for provider responses, and enters these into QMS. It then leverages UiPath’s Communications Mining to analyze the provider’s response and determine the appropriate next steps. The process involves accessing the quality queue, searching for request numbers, entering provider responses, reviewing trip details, and filing complaints in QMS.

Implementation

The process for implementation is as follows:

  • Quality Management System (QMS): The bot accesses the Quality Control queue, reviews the complaint description, and acquires the Request Number.
  • Outlook: The bot uses the Request Number to check if there is a provider response in the inbox.
  • QMS & UiPath Communications Mining: The provider response is entered in the QMS and passed to UiPath Communications Mining to understand the context of the complaint.
  • Reveal: The bot uses the information discovered to research in Reveal and assign the case with details to a specialist in the QMS for follow-up.

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