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Hospitals no longer waste time in performing tedious and repetitive RCM tasks. Robotic process automation has paved way for efficient time management.
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ROBOTICPROCESSAUTOMATION IMPLEMENTATIONINRCMAND SIGNIFICANTTIME-SAVING www.billingparadise.com
Revenuecyclemanagementprocessesaretime-consumingregardlessofhowefficientyourmanual workforcesare.Healthcaresystemsandhospitalsservehundredsofpatientseverydayandprocessing that amountofdatathroughtheRCMworkflowistime-consuming.Manualworkforcescanonlyachievesomuch inadayandburnoutisatitshighestwhenitcomestorepetitivetasksandcomplexprocesseslikeobtaining priorauthorizations.Roboticprocessautomationhelpsinresolvingthisproblembyfunctioningasyour manualworkforceinjustafractionofthetimeandcostscomparedtomanualworkforces,withthe implementationofRPAyourstaffcanfocusonmorecorefunctionsoftherevenuecyclemanagementrather thanverifying,enteringandvalidatingthousandsofpatientdata. Let’sdivedeeperanddiscussthetime-savingcapabilitiesofRPAwhenimplementedinRCMprocesses. Introduction www.billingparadise.com
Timestudiesconductedbylargehealthcareorganizations AccordingtosurveysconductedinBaylorScott&WhiteHealth(BSWH),beingahealthsystemcontaining 52hospitalsacrossthenationcalculatedthatmanualworkforcebillingtakes5-7minutesdepending uponthecomplexityoftheservicesrendered.IftheservicesprovidedareintheERandthepatientneeds surgeryafterthesurgeryiscompletedtheinpatientbillingtakesmoretimethanthatoftheoutpatient visitsand its accuracy is in question and usually, it is not 100%. That’s whyhugehealthsystemslikeBSWH implementedRPAintheirRCMworkflow.AftertheimplementationofRPA,hospitalsandhealthsystems canhandlethesetime-consumingRCMbillingtaskswith70%withoutcreatingstaffburnoutandhuman error. www.billingparadise.com
Timestudiesconductedbythecountyandstatehealthcareorganizationsprovidedreal insightsonhowmasscovidtesting,screening,andvaccinationbillingwassignificantlyreduced byimplementingRPAfor certaindataverificationprocessesinRCM.Thesegovernment healthcareorganizationsactuallyinformedinnewsarticlesthatroboticprocessautomation technologyhasquickerandmoreaccuratebillingforCOVID-19testingby90%ormore,RPAbots maketheinitialdiagnosisbychecking thedatawiththespecimenscollectedandthencollate thisdatawiththeCOVIDtestresultsandtheirmedicalchartsinthehospital’sEHR. Whileasignificantreductionintimefor alloftheseRCMprocesses,robotic processautomationcanperform complextasksandgetthemdonein seconds,alongwithmaximum productivityand0%marginoferror, andbeingabletorun24/7365days roundtheclockthroughouttheyear, RPAtechnologycanincreasethe productivityofyourbillingstaff,letting themfocusontasksthatmatterand corefunctionsofyourhealthcare organization. www.billingparadise.com
TherearenumerousRCMprocessesthatareverytime- consumingandwilltakeevendaysfortheprocesstobe completedandtheclaimsarepaid.Mostoftheseprocesses comewithcertaincomplicationswherethebillingstaffwillneed tonavigatebetweenmultipleplatformsandverifypatientdata onthoseplatforms.UsingRPAthebotswilltakecareofthese tediousprocessesandallowyoutooverseetheworkdone. SomeoftheprocessesandRPAusesareasfollows: Priorauthorization Yes,priorauthorizationisthemostpainfulRCMprocessandit takesmostofthemanualhoursandreducesproductivityby 10%.Apriorauthorizationrequestneedsverificationofpatient benefits, patienthistory,andwhetheraparticularserviceneeds authorizationornot,thisprocesstakesaround1-2hoursper patient. www.billingparadise.com RCMprocess-specifictime-saving methodsbyRPAtechnology
Imagineahealthcaresystemorhospitalwith100patientsadayof which50patientsneedauthorizationfortheservicestobepaid.It takes50-100manualhourstofileauthorizationapplications.RPAbots willcompletethistaskin8minutesflatandwillcomplete the applicationandautomaticallysubmitittothepayerwebportals leavingyourstafftomonitoronlythe correspondenceorletter receivedfromtheinsurancecompanies. Patienteligibilityandbenefitsverification Thenextmosttime-consumingRCMprocessthereis.It’snotonly verificationofeligibilityandbenefits,butit’salsoidentifyinganyTPA, IPA,Workerscomp,orautoliabilityfortheinjuryorillnessthepatient hasvisitedthedoctor.But,alsoverifyingcoveredservices,limitations ofany,andotherplancoverageslikesecondaryorHMOs.Ittakes almost30minutestoanhourtocompletelycheckthepatient information,sometimesitgetsevenmoredifficultwhenthepatient’s insuranceinformationisincorrect. www.billingparadise.com
Incorporatingroboticprocessautomationforeligibilityandbenefitsverificationwilleliminatetheburdenofmanuallysearchingvariousresourcesandinsurancewebportals.RPAbotswilltake1-2minutestoobtainthenecessaryinformationrequiredforyourproviderandkeeptheeligibilitystatusuptodateinyourEHR,sowhenapatientreturnsforanothervisitthereisnohassleineducatingthepatientabouttheirbenefits.Incorporatingroboticprocessautomationforeligibilityandbenefitsverificationwilleliminatetheburdenofmanuallysearchingvariousresourcesandinsurancewebportals.RPAbotswilltake1-2minutestoobtainthenecessaryinformationrequiredforyourproviderandkeeptheeligibilitystatusuptodateinyourEHR,sowhenapatientreturnsforanothervisitthereisnohassleineducatingthepatientabouttheirbenefits. Patienteligibilityandbenefitsverification Patientsnowadaysliketheappointmentschedulingandregistrationprocessestobe automatedastheyare fedupwithlongcallholdtimes andpaperwork that takesatleast 45minutesperpatient.RPAbotswilldoitinjust5minutestocompletetheentireprocess andthedataobtainedfromthepatientis100%accurateleavingthefrontofficestaffto assistpatientswhoarephysicallypresentinthedoctor’sofficeduringthevisitcreatinga patient-friendlyenvironment. www.billingparadise.com
MostoftheRCMerrorsoccurduringthechargecaptureandentryprocess,havinganRPAbotperformthese taskswillcreatefewererrors.RPAbotsarecapableofcapturingcharges,entering,andfilingtheclaimtothe respectiveinsurancecompaniesinamatterof2minutes, compared to manual chargecaptureandentry whichtakesaround20-30minutesperclaim. GiventhefacttheRPAbotscrossverifyeachandeverypiece ofinformationincludingchartsandpatienthistorybefore submissionoftheclaimsensuringthatthesameservicesare notprovidedtopatientsinthefollowingvisitsreducing duplicatedenials. Paymentpostingandreconciliation AlthoughmostinsurancecompaniesuseERAaspaymentdatathroughEDI.Mostpayersstillusecorrespondence,letters,anddenialEOBsthroughmailaspaperdocuments.Ifthesedocumentsaretobeenteredmanuallyittakesmorethan1hour.OCRenginesinRPAbotswillautomaticallyextractthedatafromthesescanneddocumentsandautomaticallypoststhepaymentandthenlogseachmanualdocumentforfuturereview,reconciliation,andaudits. www.billingparadise.com ChargeCaptureandentry
postingandreconciliationonlytakes30secondstoreadeverydocumentandthenusethatdatatopostpayment saving your stafftimeandallowingthemtoidentifythereimbursementand otherimportanttasks. Denialmanagementandappeals Claimdenialsarehardtotrackaccordingtodenialsandthe responsiveactionsneedtobetakenforreimbursement.Alldenials havetimelimitstorebuttalordisputerangingfrom30-120days.Most appealtimelimitsrangefrom90-120days. Correctedclaimsandreconsiderationtimelimitsarearound30-90dayswhichexceededthedeniedclaims reimbursementtimereductionresultinginlatesubmissionandnopayment.RPAbotswillanalyzedenialscreatingappealformsandsubmittheminthedesignatedpayerportalswithin8minutes,comparedto manualdenialsandtheappealprocessittakes45minsforaclaimtobecompletelyreviewed,corrected,or appealed. Roboticprocessautomationcreatestimelydenialanalysisandsegregatesthedenialsbycategories,time limits,andagaintosetyourpriorities. www.billingparadise.com Roboticprocessautomationimplementationforpayment
Robotic processautomationcreatesanenvironmentwhere yourmanualworkforcedoesnotlookattheclockevery5 minutestofastentheprocess. RPAbotsareessentialformanyspecialtypracticessuchas radiology,labs,inpatienthospitals,andsurgerycenterswhere loadsofpaperworkaredone. Itallowspracticestoperformwithlessstressandbeonestep aheadoftimeforallactivities. Besides,patientsalwaysloveahospitalorclinicprovidingcare inatimelymanner,inreturn,theywillrefermorepatientstoyour networkforthespeedyserviceandrecoverytheyreceive. BIllingParadiseRPAexpertsareskilledinRCMandprogramming RPA,discussmoreaboutimplementationwithourexperts! www.billingparadise.com Conclusion
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