Business Problem

This solution was developed for one of our international clients, who needed to record the Therapist’s reports and submit them to Insurance companies.

Collecting and compiling data into detailed reports for insurance providers was time-consuming, often taking 14-16 hours per report. However, insurance only pays for consultation time and travel.

Business Solution

To streamline this process and improve efficiency, we empowered an AI-powered solution. This solution automated the generation of participant reports, significantly reducing the time and effort required by Therapists to generate reports without compromising the correctness and uniqueness of their organization.

By leveraging cutting-edge technologies such as machine learning and natural language processing, we created a system that assisted Therapists in quickly producing accurate and comprehensive reports in a couple of hours as against the weeks’ time prior to the solution.

Also, the standardized report structure helped reduce rework and improve the quality of the report.

The diagram below shows the product landscape.

Approach

1. The Therapist communicates with the participant to gather relevant information about their condition, utilizing the Therapist and participant communication module.
2. The Therapist accesses the application through the user interface, inputting prompts and keywords to initiate the report-generation process.
3. The Response Processor API interprets the prompts and generates appropriate responses using the language model, based on the input provided by the Therapist.
4. The Dataset Builder/Trainer module was invoked to update or fine-tune the language model based on new data.
5. The Template Selector assists the Therapist in choosing an appropriate report template based on the participant’s condition and requirements.
6. Using the selected template and generated responses, the Report Builder constructs the initial draft of the participant report within the application.
7. The Therapist reviews and adjusts the report as necessary using the Report Adjustment module, ensuring accuracy and completeness.
8. Once finalized, the final Report is ready for submission to the insurance provider.
9. The insurance provider receives and reviews the submitted report, processing it for reimbursement or the Therapist’s relevant actions.

Challenges

The client had very few previous reports to train the model.  So, the accuracy of the document was Therapist coming up to the expected format as the Model requires considerable parameters to train itself hence some reports were taken from the web and even we had to fine-tune the prompts so that the reports were generated in the expected format.

Conclusion

After considerable training, we were able to generate Accurate Reports saving rework time, and the amount of time to generate the reports was reduced from 15 days to a couple of hours reducing the report costs drastically in terms of dollar value and turnaround time.

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