HP Automation Planner
Healthcare revenue cycle automation planning tool with AI-powered risk scoring and workflow diagnostics.
Open Live AppThe HP Automation Planner is a comprehensive healthcare revenue cycle automation platform designed for HealthPrime. It demonstrates a structured approach to identifying, prioritizing, and implementing automation opportunities across claims processing workflows. The tool centralizes workflow diagnostics, product vision alignment, user story management, automation intake forms, and AI-powered claims risk scoring into a unified operating system for revenue cycle teams.
Healthcare revenue cycle teams face mounting pressure from high denial rates, inconsistent workflows across teams and facilities, manual pre-submission errors that could be caught earlier, fragmented processes without centralized automation, and lack of proactive automation to scale operations efficiently. Teams need a systematic way to identify automation opportunities, prioritize them based on business value and technical feasibility, and implement standardized workflows that reduce manual intervention and improve clean claim rates.
- •Diagnose current-state workflow issues including manual pre-checks, missing data, broken workflows, and lack of standardization
- •Identify critical pain points driving automation needs: high denials, rework loops, redundant actions, and inconsistent quality
- •Define product vision with mission alignment and North Star KPI (Clean Claim Rate)
- •Track supporting KPIs: First Pass Acceptance Rate, Denial Rate, Cost-to-Collect, Touch Time Reduction, Automation Coverage, and Rework Rate
- •Manage product backlog with user stories ranked by value-complexity matrix
- •Submit automation opportunities via structured intake forms capturing workflow areas, pain points, business value, and technical feasibility
- •Review claims with AI-powered automated risk scoring to prioritize high-risk claims for review
- •Filter and search claims by patient, payer, eligibility status, and risk level
- •Workflow Map & Journey Overview: Documents current state issues (manual pre-checks, missing data, broken workflows, lack of standardization) and pain points (high denials, rework loops, redundant actions, inconsistent quality)
- •Product Vision Dashboard: Mission statement, North Star KPI (Clean Claim Rate), and supporting KPIs with clear definitions
- •Product Backlog & Prioritization: User stories ranked using value-complexity matrix with acceptance criteria and role assignments
- •Automation Intake Form: Structured submission form for automation opportunities with fields for workflow area, problem description, user roles affected, pain points, root cause analysis, business value score, automation feasibility, standardization impact, dependencies, and success metrics
- •Claims Dashboard with AI Risk Scoring: Review all claims with automated risk scoring (High, Medium, Low) based on eligibility, coding, payer patterns, and historical data
- •Claims Search & Filter: Search by patient name, claim ID, or payer with filtering by risk level and eligibility status
- •Claims Detail View: Access individual claim details including patient info, payer, CPT codes, ICD codes, billed amount, eligibility status, and risk assessment
- •Eligibility Verification: Real-time checks for active coverage before submission
- •Coding Validation: Automated validation of CPT and ICD code combinations
- •Workflow diagnostics capturing manual processes and identifying automation opportunities
- •KPI definitions and formulas for measuring revenue cycle performance
- •User story intake with value and complexity scoring for prioritization
- •Automation opportunity submission with structured fields and validation
- •Claims data ingestion from EHR/practice management systems
- •AI risk scoring engine analyzing eligibility, coding patterns, payer behavior, and historical outcomes
- •Real-time eligibility verification via payer API integrations
- •Coding validation against CMS and payer-specific rules
- •Risk score calculation and assignment (High/Medium/Low thresholds)
Landing Page - "If This Is What I Build in Less Than 90 Minutes, Imagine What I Can Build With Your Team"
Workflow Map & Journey Overview - Current state diagnosis and pain point identification
Product Vision - Mission alignment with Clean Claim Rate as North Star KPI
Product Backlog & Prioritization - User stories ranked by value-complexity matrix
About This Prototype - Challenge, approach, and product thinking methodology
Automation Intake Form - Structured submission for automation opportunities
Claims Dashboard - AI-powered risk scoring for prioritizing claim review
- •Real-time integration with Epic, Cerner, Athena, and other EHR systems
- •Automated claim submission workflow with pre-submission validation gates
- •Predictive denial analytics identifying patterns before submission
- •Automated claim scrubbing with rule engine for payer-specific requirements
- •Dashboard for tracking automation ROI with time saved, error reduction, and clean claim rate improvements
- •Team collaboration features for reviewing flagged claims and resolving issues
- •Historical trend analysis showing denial patterns and automation impact over time
- •Slack/Teams notifications for high-risk claims requiring immediate review
- •Integration with revenue cycle analytics platforms for comprehensive reporting
- •Machine learning model retraining based on claim outcomes to improve risk scoring accuracy
- •Workflow SOP generation with step-by-step procedures and validation plans
- •Multi-facility support with standardization tracking across locations