Boost Staff Productivity and Cut Costs with RPA in Healthcare

With staffing shortages still on the minds of healthcare finance leaders, it’s important for hospitals and health systems to consider time and cost-savings technology options, such as robotic process automation (RPA). RPA can easily adapt to fluctuating volumes and offload repetitive tasks traditionally handled by staff, ultimately increasing staff productivity.

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 – more than 6 in 10 respondents (62%) in a recent FinThrive survey said at least implemented a few automation tools within their RCM workflows. An additional 38% of organizations said they are exploring automation pilots for their own teams.

The FinThrive survey also discovered which areas healthcare organizations are prioritizing their automation investments most in the coming year:

• Denials and underpayments (63%)

• Prior authorization (57%)

• Documentation & coding (43%)

• Claims processing (33%)

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.

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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.

Using FinThrive, healthcare organizations can:

• Boost efficiency and reduce errors

• Streamline payer coordination

• Optimize the eligibility and denials workflows

• Automate and simplify regulatory compliance

  RELATED: The Essential Buyer’s Guide for Healthcare RCM AI and Automation

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 us.