Revenue cycle management (RCM) is one of the most critical business processes for healthcare providers. Essential for bringing money into organizations, RCM involves managing all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue.
These functions, of course, have to be performed efficiently and accurately to successfully manage the organization’s finances. Unfortunately, RCM is also a very routine and repetitive process — which makes it highly prone to costly human errors.
For that reason, many healthcare providers today are turning to a technology-enabled solution: Robotic Process Automation (RPA). Basically, RPA allows organizations to automate repetitive and routine tasks with the help of robotic processes, thereby increasing efficiency and reducing mistakes.
Solving RCM challenges with RPA
RCM includes a wide variety of tasks, ranging from capturing medical records to managing payments and denials. Key RCM concerns that can be automated via RPA include:
- Patient registration and appointment scheduling. Phone-based patient interactions tend to be time-consuming and inefficient. To start, patients are often made to wait on hold while healthcare staff juggle multiple priorities. Once connected, patients have to share significant personal information, opening the door to typos, misspellings, and other errors for the person taking down the information on the receiving end. RPA bots solve this problem by automating the process, verifying information on the go to increase accuracy and speed up the task.
- Insurance verification. Before a patient's appointment, a healthcare provider must verify the patient's insurance coverage. Done manually, this process can be incredibly time-consuming and prone to errors, as it involves typing individual patient information into health record systems and checking for coverage. With RPA, however, the process is dramatically simplified. A robot is programmed to automatically verify insurance coverage by pulling patient information from the electronic health record (EHR) system and checking it against the insurance provider's database — reducing the risk of errors and scheduling appointments more efficiently.
- Claims processing. Healthcare providers must submit claims to insurance providers in order to collect revenue, but this process can be lengthy and tedious for people tasked with the job. With RPA, a robot can be programmed to automatically populate claim forms using patient information from the EHR system before checking for errors and submitting the claim to the insurance provider. Automating claims processing not only saves time but also increases the chances of a successful claim submission by eliminating human errors.
- Payment automation. Billing and receiving payment from patients with paper invoices and handwritten checks can be a fraught process. After all, checks can be misdated or misdeposited, and snail mail letters lost. To prevent such issues, healthcare providers can use RPA to convert paper correspondences to electronic documents and processes. This can reduce paperwork and eliminate check posting errors.
- Compliance. The healthcare industry is highly regulated, with many federal, state, and local laws that must be followed to the letter. RPA makes compliance simple with the use of robots, which can be programmed to follow established guidelines and regulations, ranging from the federal Health Insurance Portability and Accountability Act (HIPAA) to local rules. By ensuring that all claims are processed correctly and in compliance with industry standards, RPA can help reduce the risk of denied claims and penalties for non-compliance.
- Patient satisfaction. Delayed or inaccurate billing results in unhappy patients. RPA can help to improve patient satisfaction by providing more accurate and timely information about bills and payments. For example, RPA can be used to automatically send patients an electronic bill — or even a text message or email — immediately after a medical appointment. RPA can also follow up on a timely manner on unpaid bills. This can help reduce confusion and frustration for patients, improving their overall experience with the healthcare provider.
- Cost management. RPA can help healthcare providers reduce costs associated with the RCM process. By automating routine tasks, healthcare providers can reduce the need for manual labor, lowering overhead costs. Additionally, due to increased accuracy, RPA can reduce the number of denied claims, which can lead to a significant reduction in the labor required for appeals.
RPA can be a powerful tool for healthcare providers looking to improve their RCM processes. By automating repetitive and routine tasks, RPA reduces the room for error and improves efficiency — all while increasing patient satisfaction and staying compliant with healthcare regulations.
Optezo’s End-to-End RPA Services offer everything healthcare organizations need to successfully automate RCM processes. Curious what Optezo can do for your organization? Get in touch with us today to learn how we can help you realize the benefits of enterprise automation.
