Case Study: Baptist Health South Florida achieves streamlined claims processing and automated audits with Fortra Automate

Baptist Health South Florida Streamlines Claims Processing with Automate

Baptist Health South Florida, the region’s largest not-for-profit health care system with seven major medical centers, struggled with a manual, error-prone claims workflow: each facility produced many ANSI 837 inpatient and outpatient files but the ePREMIS claims system accepted only one inpatient and one outpatient file per day. Repetitive file joining, transfers, and reconciliation against the BILLSUMC summary report created delays, extra labor, and missed claims, so a team set out to streamline and automate the process.

Using HelpSystems’ Automate suite (Automate, Automate Schedule, Automate Enterprise), the team automated daily FTP downloads, merged inpatient and outpatient 837 files, securely transmitted them to ePREMIS, and parsed files to compare claim counts against the BILLSUMC report—triggering audit reports when discrepancies were found. The year-long implementation put 40+ Automate tasks into production, centralized control of thousands of daily transfers, improved consistency, reduced errors and saved significant time (clients ~10 hours/week; internal staff 5–10 hours/week).

Baptist Health South Florida

Jason Stoyles

Team's Supervisor