October 10, 2023
The healthcare industry is the third largest in the United States according to Cross River Therapy. Accordingly, the industry processes a sea of data and has complex workflows that can be mentally, emotionally, and physically draining, causing burnout for health practitioners. Nevertheless, with automation in healthcare, processes get less complicated, and services are delivered accurately to patients.
Automation helps businesses streamline workflows, create efficiencies, and become more productive. Additionally, due to the complexity of healthcare processes and systems, automation solutions can bring a noteworthy ROI to the healthcare industry.
Healthcare providers and organizations are subject to strict compliance regulations and require accuracy in their data. Leaving jobs like prior-authorization or medical coding to human teams leaves room for unintentional errors. RPA can complete these processes with accuracy.
Every single healthcare organization can benefit from automation. Here’s why:
#1. Accuracy is Essential
Accuracy is non-negotiable in healthcare, as a simple error can escalate into a life-threatening situation. Studies show that human data entry without verification measures results in an error rate of 4%. Even with verification, most human data entry hovers around a 1% error rate.
For instance, an inverted number or missed field on a claim form could cause significant problems. It might result in a claim denial or undercharging a patient, which will slow down your revenue cycle process.
Think about these questions; how much do you have to pay extra employees to manage the results of unintentional human errors? How much time does it take you to fix and resubmit claims? How many additional billing statements do you have to create to reconcile accounts?
If you are spending additional time and other resources fixing errors, it's time to automate processes to avoid inefficiencies. The extra time required to correct the effects of data inaccuracies costs your business money. You need 100% accurate data to protect your bottom line and confidently run your financial operations.
Robotic process automation (RPA) is a simple solution to the mountains of data entry required to run a healthcare organization. What’s best is that RPA operates at a 0% error rate. With automated systems, you never have to worry about errors in patient data and can operate your business with full confidence that your data is 100% accurate. Consequently, there won’t be inaccurate claims processing, billing errors, or revenue cycle delays.
#2. The Revenue Cycle is Complex
Managing the revenue of a large industry like healthcare can be rigorous. Working with insurance companies makes the healthcare revenue cycle even more complex than in other sectors.
Specific struggles in healthcare revenue cycle management include managing multiple claims, navigating complex insurance policies to determine what coverages patients are eligible for, and managing claim denials and appeals, which can quickly eat up hours of the day. Furthermore, other issues include following up with insurance providers for unpaid claims, determining coordination of benefits, and accurately billing patients.
Automation can surmount these challenges and simplify your revenue cycle processes. It achieves this by automating repetitive tasks like creating, sending and tracking invoices, posting payments to client accounts, submitting claims to insurance companies, adjusting denials, and following up on unpaid balances.
RPA can also automatically search a list of pre-existing patient conditions. The bot removes manual processes for clinicians and easily identifies the highest payer rate you’ll get from your insurance company.
Similarly, the bot can assist with the medical coding process. This saves your staff time by extracting information from electronic health records (EHRs) and matching it with the appropriate medical codes. The deployed bots also automate the admission and discharge process, patient information collection, and insurance eligibility verification, population discharge instructions, and summaries.
#3. Everything is Digital
In recent years, almost every process in the healthcare industry has some sort of digital solution. Trends show that a majority of patients have come to expect digital solutions for their care. This shift presents a slew of opportunities for organizations to improve the quality of their care, as well as an onslaught of challenges.
Using RPA, you can automate data transfer to alleviate major pain points for your whole organization. RPA can track when a patient registers in a hospital, makes doctor’s appointments, receives care, makes payments, and gets discharged. Automation takes care of the most time-consuming tasks, ensures your healthcare facility delivers quality service, records excellent patient outcomes, and takes charge of its finances.
As more medical practices and healthcare establishments rely on digital tools, there’s a growing need for automated capabilities to help get the most out of new technology. If you don't take advantage of a digital environment's possibilities, you'll spend unnecessary time and money on processes that cut your bottom line. It may also negatively affect patient experiences at every appointment.
2 Common Use Cases of Automation in Healthcare
There are a multitude of ways to implement automation in your healthcare business. These two simple use cases will highlight the benefits of automation and broaden your horizons of what automation looks like in practice.
Healthcare organizations can use RPA to automate various scheduling tasks to improve efficiency and reduce errors. Below are areas where RPA can help you schedule;
- Appointment scheduling – Your RPA tool can access your schedule and make patient appointments based on available times for their healthcare providers. As a health practitioner, it reduces your patients’ wait times and avoids double schedules.
- Registration – RPA can input information from EHRs and patient forms into your scheduling system or database. This gives you complete insight and forehand knowledge about your patient before their appointments.
- Reminders – Use artificial intelligence through RPA to save time by automating appointment reminders and notifications for you and your patients. With automation, you can send personalized messages, avoid no-shows, and prevent revenue loss.
- Insurance verification – RPA tools can access insurance company portals to retrieve and import patient coverage information. This process lets you verify a member’s identity, claims, and benefits.
- Referrals - Data exchange during referrals is more efficient through RPA. A primary care physician (PCP) can refer a patient to a specialist through a stress-free process. Also, the PCP uses automated tools to pull information from EHRs or other internal systems and schedule appointments with specialists.
Automation streamlines almost all of your revenue cycle management processes. Here’s how;
- Creating and tracking invoices – Improve your billing systems by using RPA to create, send, and track invoices based on services rendered. This prevents billing your patients incorrectly.
- Verifying eligibility – Automatically verify eligibility and coordinate benefits based on a patient’s insurance information. RPA fast-tracks determining whether a patient is eligible for insurance coverage and whether the coverage is active. Without this confirmation, your healthcare organization may not be paid or paid incorrectly, affecting your revenue.
- Coding - Let a bot extract information from electronic health records (EHRs) and match it with the appropriate medical codes. The bot can even monitor lists of pre-existing conditions to make sure you are getting the highest payer rate possible.
- Monitoring payment status – RPA helps you oversee and track payment status from patients and payers.
- Updating patient records – Automatically update account records when payments come through so you always see the current balance.
The revenue cycle management with RPA is where many healthcare businesses yield the biggest return on their RPA tools. This is because it significantly lowers costs for administrative tasks and ensures 100% data accuracy.
Automation is a Necessity
Automation has changed from being "nice to have" to an absolute necessity in healthcare. Concerned about offering quality care and maintaining accuracy in healthcare? We can help you implement automation in your business to streamline workflows and maximize efficiency for your staff. Schedule a call with us today to learn more about our custom solutions.