Today healthcare operations are undergoing a disruptive transformation as automation is bringing forth brand new capabilities across a wide range of business processes. Leading healthcare providers are adopting new management paradigms and novel technology strategies to capitalize on what this boom can offer them. Revenue Cycle Management is among the most attractive business functions for healthcare providers to begin their automation journey. Technologies such as Robotic Process Automation (RPA), Intelligent Automation, and cognitive methods such as Artificial Intelligence (AI) can help healthcare organizations improve efficiency and ultimately reduce the cost to collect, which is a key for improving cash flow.
With its emphasis on workflow and analytics as foundational technologies, revenue cycle business processes are especially amenable to improvement using RPA. For example, with respect to Accounts Receivable (A/R), the role of RPA is to drive efficiencies in the level of effort required to collect from payers and patients, while also streamlining upstream processes such as eligibility and authorization. When combined across a single unified workflow platform with sophisticated analytics, the impact of RPA on the overall financial returns to healthcare providers both large and small can be significant.
As government and commercial payers reduce reimbursement rates and providers are forced to maintain compliance with a bewildering array of new and evolving regulations, the need for automation to manage these challenges have never been greater.
There are few means to overcome this challenge without additional cost or complexity. A proven way to accomplish this goal with significant benefits is leveraging RPA to improve Revenue Cycle Management services.
BOTs can form a digital layer on top of existing Electronic Health Records (EHR) and financial management systems to take over the routine, repetitive and often time-consuming tasks within the revenue cycle. As BOTs function 24/7 across an enterprise in complete harmony with staff, there is great potential to achieve higher levels of productivity and efficiency.
Actionable or enhanced claim data processing represents another area where RPA is having a significant impact on revenue collection. For example, it is not uncommon for account information to be lumped together by payers, often simply because of incorrectly documented subscriber identifiers. Obtaining remit information though a BOTs driven system from payers to supplement claim status responses for a “Super 835” provides a much more comprehensive view of the claim. Adding remit data such as patient responsibility to claim status responses drives higher call avoidance rates.
Using our advanced analytics engine to drive workflow and put effort where it will be best rewarded, our BOTs can retrieve claim status and provide detailed claims resolution data far more quickly than non-automated methods. By alerting the staff as to which claims are likely to be denied and for what reason, we resolve claims more quickly and with higher quality.
