Revenue Cycle Management (RCM) plays a crucial role in healthcare systems, directly impacting operations and patient care. As a result, companies face increasing pressure to enhance the efficiency of this cycle. In 2022, the United States estimated its efforts to combat cycle congestion at over $140 billion, with a compound annual growth of 12.5%. Despite the availability of technology and significant investment, many businesses have yet to fully reap the financial benefits of implementing technological solutions, such as RCM automation. Confusion about which solutions will deliver the greatest benefits and where to start often frustrates providers trying to tackle revenue cycle issues with technology. Automation can easily address the first part of this challenge. The revenue cycle includes numerous manual, labor-intensive processes that automation can streamline, allowing staff to dedicate more time to direct patient care and services. However, pinpointing which operations would benefit most from automation presents a greater challenge. Many providers struggle to implement automation because they find it difficult to identify where to allocate limited financial resources for maximum impact. Here are some ways intelligent automation (IA) can assist any organization.
Enhancing Patient Interaction from the Outset
Insurance Verification
Automate the tedious tasks that need to be completed before a patient enters the examination room, such as confirming insurance, identifying covered services, and assessing the patient’s financial obligation. By automating these processes, you can accelerate the transition to active patient care and enable staff to deliver a more personalized and enhanced patient registration experience. After the registration clerk gathers the necessary data from the patient, intelligent automation can take over and transit that information for verification through the electronic health record (EHR)or an online portal. The bot then examines the policy status, deductibles, authorization requirements, benefits cap, and any restrictions. Once the system automatically updates the patient’s file with the verification details, the registration clerk can inform the patient of the key information while intelligent automation initiates the pre-authorization process.
Improving the Patient and Clinician Journey During Active Care
Clinical Documentation
Physicians miss out on valuable time for direct patient care because they spend between 4.5 and 6.5 hours each day taking notes and reviewing medical information. By leveraging intelligent automation (IA), physicians can automate many of the tedious tasks associated with clinical Documentation. Bots can gather relevant data from electronic health records (EHRs), assist with coding, input data into forms and charts, and check documents for errors. By streamlining clinical workflows, automation allows physicians to offer more personalized and compassionate care, thereby enhancing the overall patient experience.
Conclusion – Closing the Cycle with a Satisfied Patient Experience
Third-Party Follow-Up
Following up with payer organizations after providers file claims is essential for monitoring the claims’ progress and addressing any potential issues. Claims specialists reach out to clients via phone and email to confirm receipt of claims, identify inconsistencies, and manage denials. Given the complexity of insurance billing, manual follow-up requires significant effort and meticulous attention to detail. Healthcare organizations can streamline many repetitive follow-up processes by utilizing RCM automation. Automated systems monitor claims in real-time and flag any issues for prompt resolution. When combined with AI, these systems can also predict potential claims denials using historical data.
Read Whitepaper Automation in RCM Streamlining Processes and Improving Efficiency
