RPA is great for RCM
The revenue cycle is a complex process in healthcare. A wide range of things need to happen correctly for claims to be approved. Opportunities for claim denial can stretch all the way back to the intake process and one error can break the chain of a successful claim.
Bots have proven very effective in automating the RCM process, particularly around:
Ensure data integrity when registering new patients, including demographic and insurance information.
Without proper authorization, you risk providing services without compensation leading to increased costs and reduced revenues. Bots can examine clients for pending consumption/expiration of authorizations and email billing staff or service providers to update this information proactively.
Prepare billing and ensure each claim has all the requisite information to minimize follow-ups and denials.
Submit claims and invoices, each with unique rules and formatting, all without human intervention.
Statusing your claims in a diligent and timely manner is key to prioritizing follow-ups and avoiding denials.
The quicker you collect patient responsibility, the greater the likelihood you will get paid. By automating sending invoices, charging credit cards and sending receipts, you can complete the patient responsibility collections process as soon as you know they have a balance.
Many third-parties do not provide EOBs electronically in a batch format that can be uploaded into an EHR or billing system. This often requires billing staff to login to 3rd-party tools, manually search for claims and copy/paste the results to create accurate financial results in their EHR.
What are your tedious RCM processes?