Automated financial aid assessment workflow

Purpose

1.1. Automate the end-to-end assessment for patient financial aid eligibility, minimizing manual data entry, expediting approvals, ensuring compliance, integrating insurance checks, and initiating follow-up communication with patients and insurers.
1.2. Streamline documentation gathering, validate patient financial data, auto-calculate eligibility, log decisions for audits, and notify all stakeholders.

Trigger Conditions

2.1. New financial aid application submitted via webform or EHR portal.
2.2. Receipt of updated insurance or financial documentation.
2.3. Scheduled patient intake or eligibility review date.
2.4. Change in patient insurance or billing status.

Platform Variants

3.1 Salesforce
• Feature/Setting: Process Builder/Flow – Automate record updates and trigger eligibility assessments on new form submissions.

3.2. DocuSign
• Feature/Setting: Envelope Events API – Auto-send and track documentation requests, return signed documentation to workflow.

3.3. Twilio
• Feature/Setting: SMS API – Notify patients and billing staff of required documents or assessment outcomes.

3.4. Google Drive
• Feature/Setting: Drive API – Store, retrieve, and share submitted financial documents for assessments.

3.5. AWS Lambda
• Feature/Setting: Event-triggered functions – Run custom assessment calculations or document validation on file receipt.

3.6. Zapier
• Feature/Setting: Zap triggers/actions – Link form submissions to EHR or CRM and initiate workflow steps.

3.7. Stripe
• Feature/Setting: Billing API – Validate payment methods, create payment plans based on eligibility status.

3.8. Plaid
• Feature/Setting: Auth & Transactions endpoint – Retrieve patient bank/income verification for financial assessment.

3.9. Oracle NetSuite
• Feature/Setting: SuiteScript – Automate record creation, eligibility status updates, and reporting.

3.10. Microsoft Power Automate
• Feature/Setting: Workflow builder – Automate notifications, document routing, and eligibility status changes.

3.11. QuickBooks Online
• Feature/Setting: Invoice API – Generate invoices or financial summaries triggered by eligibility assessment outcome.

3.12. Box
• Feature/Setting: Webhooks/API – Archive and synchronize submitted financial documentation.

3.13. Slack
• Feature/Setting: Incoming Webhooks – Notify finance or case management channels of status updates.

3.14. BambooHR
• Feature/Setting: Webhook/API – Auto-validate internal staff involvement for compliance (if HR review required).

3.15. SendGrid
• Feature/Setting: Mail Send API – Trigger email communications when assessments are approved or denied.

3.16. Redox
• Feature/Setting: Data Ingest API – Integrate patient EHR financial data into workflow.

3.17. Medisoft
• Feature/Setting: Integration API – Trigger billing/aid review steps directly from medical billing events.

3.18. OnBase by Hyland
• Feature/Setting: Workflow automation – Route application documents for review by specific roles or criteria.

3.19. Monday.com
• Feature/Setting: Automations API – Create tasks for missing information or further review.

3.20. Adobe Acrobat Sign
• Feature/Setting: API for e-signature – Automate capture of signed aid applications and attach to patient profiles.

Benefits

4.1. Minimizes manual data entry, reducing errors and operational cost.
4.2. Accelerates aid approvals and payment plan generation, improving patient onboarding.
4.3. Ensures documentation compliance and secure information handling.
4.4. Enables clear audit trails for eligibility decisions.
4.5. Improves communication with patients, staff, and insurers for transparency and satisfaction.