Top 5 Mistakes in Claims Management – And How to Avoid Them
Claims management accuracy and efficiency are crucial for hospital billing, accounting and finance professionals. However, common missteps can cause...
As the healthcare industry embraces digital transformation, automation has emerged as a promising approach to challenges that threaten the financial stability of organizations. In fact, 50% of providers are projected to have invested in automation by the end of this year.
The benefits of robotic process automation (RPA) technology are multi-faceted. RPA can automate repetitive and rule-based tasks across different systems, enabling healthcare finance leaders to achieve their top objectives, such as reducing costs, increasing revenue, managing staffing shortages and enhancing the patient financial experience.
Revenue cycle management (RCM) automation has become a top priority for many healthcare executives, and its value is being widely recognized. KPMG Research indicates that RPA can reduce revenue cycle costs by 25-40% for hospitals and health systems, while nearly doubling the productivity gains achieved through outsourcing specific processes.
As with any technology, RCM automation is not a one-size-fits-all solution. For the best results, check out these three tips to improve an RCM automation strategy.
Tip #1: Set specific RCM automation goals
At the beginning, it’s best to automate the “low-hanging fruit” – data-rich tasks that are manual and repetitive. For example, don’t implement automation to achieve the goal of “improving your claims process.” Rather, drill down to a specific task within your claims process, such as scrubbing Medicare Advantage claims to find any potential errors prior to submission. This is a repeatable task that will save RCM teams significant hours of work and help improve efficiency.
From there, explore other specific parts of a workflow that would benefit from automation. Over time, setting automation goals and scaling slowly will allow your team to diligently build a robust process that produces greater ROI in your RCM strategy.
Tip #2: Communicate to your staff what RCM automation is and isn’t
Automation is often misconstrued as a job replacement strategy, but it's crucial to emphasize its role in enhancing staff productivity and satisfaction.
When communicating to staff about the benefits of using automation as part of an RCM strategy, consider highlighting these key points:
Staffing shortages are rampant in RCM departments
A recent HFMA survey of healthcare finance leaders found all respondents with at least one open revenue cycle role, and nearly 20% had more than 30 vacancies. Staffing constraints can lead to inefficiencies that can burden current employees, delay payments and reduce reimbursements. In fact, 48% of healthcare finance leaders reported an increase in patient billing errors due to current staffing shortages. Shrinking workforces in RCM not only impacts productivity, but also the morale of those left managing the operations. The “do less with more” tactic is no longer an effective strategy to drive yield in RCM. Successful organizations must automate, not recreate their workflows.
Industry analysts project hospitals won’t see a return to normalcy, in regard to the workforce, for several years. And with contract labor expenses up by 257%, finance leaders must embrace technological solutions for the betterment of their organizations and staff.
Automation improves the experience for current staff
Leaders know they have dedicated, talented staff members too often engaged in low-value work, such as status checks on claims. That’s where RPA can be valuable.
For understaffed RCM departments, RPA can take over the tedious manual tasks for current employees and redirect staff to more fulfilling work such as revenue capture or payer modeling. As a result, job satisfaction rises, all while RPA can deliver significant ROI for the organization – as much as 8X for some tasks.
Automation can’t replace the human touch
While automation and RPA technology can provide tangible value to healthcare organizations, there’s no replacement for staff providing personal, meaningful patient care, such as saying hello to a patient as they walk in, explaining their bills, directing them to a facility or showing empathy in conversation.
Automation frees up staff to focus more on higher-value tasks and being more present to patients in the office. Most people don’t sign up to work in a hospital or health system to simply work on manual tasks repeatedly. Fortunately, thanks to technology and automation, there is more opportunity for everyone to produce meaningful work and have a bigger impact on the patients they serve.
Simply put, an investment in automation is an investment in a healthcare organization’s current employees.
Tip #3: Partner with an organization who serves as an RCM expert
As mentioned earlier, automation is not a one-size-fits-all solution. While starting small and setting specific goals is a great way to optimize any automation strategy, it’s also important to remember that no two healthcare organizations are the same.
Every organization has its own unique set of challenges, workflows and needs. Therefore, the implementation of automation or RPA technology must be as nuanced as the problems any health system or hospital is looking to solve.
Collaborating with an experienced RCM technology vendor can provide valuable insights and expertise. They should be able to share technology adoption best practices and help an organization create a strategic plan to implement automation into various workflows.
In short, a vendor can help an RCM department avoid automating bad processes, and instead, ensure the technology is designed to address any unique needs for greater ROI.
Taking the time to research and choose the right RCM partner is an investment that can yield substantial returns in terms of improved financial performance and overall satisfaction.
The tangible benefits of RCM automation make it a worthwhile investment for any healthcare organization. By taking these steps, your team can effectively harness the power of RCM automation to achieve significant improvements in efficiency, productivity and overall financial performance.
