How Healthcare Organizations Can Improve Their Insurance Verification Process
In the healthcare industry, accurate insurance verification is crucial for patient care and overall revenue. Despite its importance, many healthcare...
Markets
Solutions
The Revenue Cycle Management Technology Adoption Model (RCMTAM)
RCMTAM offers healthcare providers a comprehensive tool to evaluate and enhance financial and technological performance through an evidence-based, five-stage maturity model.
Featured Content
In May 2022, more than 400 healthcare finance leaders reported revenue cycle workforce shortages, with almost 20% seeing 30 or more vacancies.
With no end to staffing shortages in sight, it’s important to consider time and cost-savings technology options. For instance, robotic process automation (RPA) can easily adapt to fluctuating volumes and offload repetitive tasks traditionally handled by staff, ultimately increasing staff productivity.
What is RPA in healthcare?
First, it is important to clarify what RPA is not. Different from other “software” that requires a human to log in with a password, RPA software robots or “bots” are given a password, enabling them to log into systems to perform work humans normally would do. In this way, RPA automates business processes by replicating the actions of a human worker.
Beyond simple screen scraping and keystroke emulation, RPA is also evolving to more sophisticated solutions that interact directly with objects in the user interface of systems, leveraging artificial intelligence to enable more robust automation.
RPA has caught the attention of healthcare organizations in particular. More than three-quarters of respondents (82%) to a 2021 HFMA survey revealed they are on their automation journey. In addition, Gartner anticipates that half of all provider organizations will invest in RPA technology over the next few years, mainly driven by payment reduction and the need to bolster the patient experience.
To improve payment reduction, we need to take a close look at how RPA handles medical claims and denials. Automation simplifies the claims process, helping revenue cycle teams work more efficiently and effectively to process high-priority claims.
Bots ease the claims process
If you were to watch an ICN/DCN bot in action, you would see it create and pull a worklist from a medical claims system to search for matches. When a match is found, the bot pulls in specific data elements, detailing these on a daily productivity report. It also updates ICN/DCN claims, clears the edits and gets claims out the door. This continues daily, with users getting a completely new list of claims out the door every day.
Learn more: How RPA Improves Your Revenue Cycle
Unique FinThrive RPA architecture
The FinThrive RPA architecture utilizes “micro bots,” which are standardized components that work together to deploy a process. This allows reuse and enables FinThrive to maintain components across multiple processes to reduce downtime.
FinThrive also leverages artificial intelligence to create even more sophisticated processes for users, enabling bots to recognize information on insurance cards, for instance.
Get started using RPA in your health system
A clear, guided path is recommended before you deploy RPA, including working with a vendor that has technical expertise and healthcare revenue cycle knowledge. Approximately 70% of the work is in identifying processes that will deliver the most value, optimizing and mapping these processes in advance of an RPA implementation.
Quantifying the labor savings
For hospitals and healthcare organizations that embark on an RPA implementation, the average labor savings can be dramatic. For example, 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 greatly benefit, often eliminating two or more FTEs.
To learn how RPA solutions can help your hospital or healthcare organization and lead to increased revenue cycle success, visit our RPA solution page or contact FinThrive.
In the healthcare industry, accurate insurance verification is crucial for patient care and overall revenue. Despite its importance, many healthcare...
The 2024 HFMA Annual Conference returned to Las Vegas this year…and man was it HOT! Not only did we have triple-digit temps all week, the conference...
Navigating the complex landscape of healthcare can be challenging for patients, especially when it comes to understanding and managing insurance...
In an era marked by rapid technological advancements and unforeseen challenges, healthcare institutions are increasingly vulnerable to interruptions....