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...
A lot has changed with revenue management in the last three years, especially the transition from traditional onsite employees to remote employees, leading to persistent staffing gaps.
On the heels of the shift to remote work, staffing gaps have become a top challenge for finance leaders. In a previous post we explored how to work smarter with robotic process automation. With RPA, healthcare organizations enable their staff to focus on higher-priority, problem-solving tasks while RPA focuses on other repetitive tasks. Here are four top reasons RPA can improve your revenue cycle.
1. Increases efficiency without sacrificing accuracy
RPA is a useful and necessary tool for improving productivity and effectiveness of the revenue cycle team. As health systems across the country implement this technology, the results have shown reduced costs, increased revenue capture and a decrease in denials. KPMG Research suggests RPA could reduce revenue cycle costs by 25 to 40% for hospitals and health systems, with nearly double the improvements in productivity of outsourcing specific processes.
2. Improves claims by reducing errors
Health systems are also seeing an improvement in accuracy and effectiveness of claims due to the reduction in errors through automation. For instance, nearly one out of five claim adjustments at one health system stemmed from errors in manual data entry. This demonstrates the need for RPA to ease the claims process and allocate resources effectively.
3. Boosts staff performance
It’s important to note that RPA does not seek to replace humans. The goal of automation is to increase productivity of the revenue cycle team, leveraging the technology to the advantage of the staff and health system. In the above-mentioned health system, it was found that 75% of adjusted claims were not sent to the payer on time or were submitted with incorrect member or provider information. Through automation, revenue cycle leaders ensure their teams are working on the right accounts at the right time and delivering the most accurate information. This shift creates a more seamless revenue cycle where accurate claims are pushed out efficiently and revenue flows back in.
4. Improves the patient financial experience
Automation also assists the revenue cycle by improving front-end cost predictions and the codes/claims management process. According to a Forbes article, the technology adjusts to each patient to provide real-time estimates of patient cost given the patient’s insurance and billing codes. This process significantly improves the financial experience. Discussing payment options and actual cost estimates before care resulted in “60 to 100% improvements in point-of-service collections across various clinics and hospital departments.”
RPA is a useful tool to improve the revenue cycle, patient-payer experience and productivity of staff. The technology lightens the load on the revenue cycle team and ensures accurate, efficient and effective allocation of time and resources while boosting revenue capture.
How hard is it to deploy RPA?
That depends. If your healthcare organization decides to build your own bots, you’ll need in-house resources both to create and maintain your bots.
If partnering with an expert RPA resource, ensure they have a full understanding of your revenue cycle processes and that they’re committed to leveraging RPA technology for the long term. At FinThrive, our RPA deployment includes creating bots with a “smart architecture” based on shared knowledge that is maintained across multiple users. Should something go awry, issues can be addressed rapidly by our RPA experts to minimize downtime.
How much does RPA save?
The average labor savings from RPA is dramatic. One large, 50+ hospital that deployed bots for adjustment claims (XX7 type bill), eligibility denials and root cause (XX7 claims) eliminated two to four FTEs per application, resulting in ROIs up to 583%. Smaller facilities can also benefit greatly for a quick win.
To learn how RPA can help your organization do more with less, visit our RPA solution webpage or contact FinThrive, select Solutions Inquiry, and complete the short form. Our RPA experts will be in touch.
