Maximizing Revenue: The Automated Advantage
Healthcare revenue cycle management connects the clinical and financial aspects of care to ensure that providers receive appropriate compensation. This process can become complicated and time-consuming, involving lengthy forms and repetitive tasks that staff and patients know all too well. To ensure proper claims and billing, teams must retrieve information from multiple databases and systems, making it an ideal candidate for automation. Revenue Cycle Automation involves applying robotic process automation (RPA) to repetitive, rule-based procedures. In practice, this could involve:- Generating and distributing financial statements, bills, and invoices automatically.
- Simplifying the administration of medical data and enabling prompt, reliable information exchange.
- Processing digital payments.
- Gathering and evaluating performance data to extract valuable information.
Typical RCM Challenges
Already Automation is making progress in addressing some of the most widespread issues including:Reducing the rise in Claim Denials:
According to a study, a third of providers experienced claim rejections ranging from 10 to 15 percent. These rejections often stem from errors made earlier in the revenue cycle, such as providing inaccurate patient information or failing to secure pre-authorizations. RCM automation significantly reduces the likelihood of these mistakes.Making patient access more efficient:
The revenue cycle begins on the wrong foot without a warm digital front entrance. Automation can enhance patient scheduling and registration, ensuring that patient data is collected and stored promptly and accurately.Increasing the rate of collecting:
Patients who pay for their care, a growing trend, prefer to know the estimated cost of their treatment in advance. When patients are unaware of their financial obligations, providers often find themselves playing catch-up. Automated technologies can create a more robust cash flow by delivering accurate forecasts and facilitating pre-service payments.Increasing the availability of data insights:
Managers are collecting more data than ever before, yet they struggle to process it and extract valuable insights. This irony highlights a significant challenge in revenue cycle management. RCM automation can help identify patterns in claims and collections, turning data into actionable insights.Rapid Reimbursements, Real Results: Six Automation Wins
Quick Paybacks, Actual Outcomes: Six Automation VictoriesAccurately and promptly record patient access information:
The first step in streamlining the revenue cycle and healthcare procedures is enhancing patient access. By replacing manual processes and fragmented systems with integrated software solutions, healthcare organizations can accelerate the revenue cycle, reduce errors, increase efficiency, and provide patients with greater convenience and transparency. Patient estimates automatically generate an accurate breakdown of what a patient is likely to owe. To encourage prompt payment, it includes features such as prompt-pay discounts, financial aid guidance, and online payment links.Streamline collections and prioritize key accounts:
Healthcare collectors often face resource drain. Automating repetitive aspects of the collections process lightens staff workloads. The collections Optimization manager uses automation to analyze payment history and other financial data, directing patients’ accounts to the appropriate collections pathway. By scoring and segmenting accounts, providers avoid wasting time on incorrect accounts. This allows patients who can pay on time to do so without unnecessary hassle, resulting in quicker payments for providers.Automate manual processes to combat staff burnout:
Healthcare providers continue to struggle with persistent workforce shortages. 96% of participants in a recent staffing survey stated that this was having an impact on patient collections and payer reimbursements. Automation can relieve busy teams of repetitive activities. Lower rates and speed up workflows, but it cannot replace highly skilled personnel.Reduce the burden of maintaining regulatory compliance:
Though not directly speeding payments, regulatory compliance is vital for avoiding delays, and penalties that disrupt revenue. Given the constant changes in regulations and payer policies, automation is essential for continuous monitoring and adaption, leading to a smoother revenue cycle and improved patient experience.Optimize the complete claims lifecycle:
Ensuring quicker and more accurate claims submission is perhaps the most obvious way that RCM automation accelerates reimbursement. Automated claim scrubbing, real-time eligibility verification, more precise coding, and streamlined status tracking all enhance the likelihood of providers receiving timely and complete reimbursement. As artificial intelligence (AI) gains popularity, providers are discovering innovative ways to enhance claims management through technology. By leveraging machine learning to identify patterns in payer behavior and uncover undocumented regulations that could lead to claim rejections, staff members can take prompt action to prevent issues. AI then uses computational logic to help personnel efficiently segment and rework denials, allowing providers to minimize downstream income loss and receive payments more quickly.Getting more precise insights into the areas for improvement:
Lastly, automation helps providers analyze and act on revenue cycle data by spotting trends, bottlenecks, and areas for improvement. Automated analyses quickly compile relevant information from multiple sources to support decision-making. By leveraging historical data, machine learning enables providers to identify the root causes of delays and take proactive steps to resolve issues. In addition to being a presenting tool, a healthcare revenue cycle dashboard allows for real-time financial health monitoring, allowing staff to streamline processes and expedite payments.Conclusion
Like any other business, healthcare institutions need to keep their cash flow positive in order to stay in business and keep helping their communities. When combined, these six revenue cycle automation techniques can overcome a number of typical roadblocks that impede growth and financial stability.Read Whitepaper Automation in RCM Streamlining Processes and Improving Efficiency
