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Efficiency, Compliance, and Savings: How RPA is Changing the RCM Game
Use Cases
3 min read


EFFICIENCY, COMPLIANCE, AND SAVINGS: HOW RPA IS CHANGING THE RCM GAME


LEARN HOW RPA IMPROVES EFFICIENCY AND REDUCES ERRORS IN HEALTHCARE REVENUE CYCLE
MANAGEMENT


Adam Bookman


Adam Bookman is an innovative marketer and thought leader in the emerging
technology space. At Optezo, he focuses on marketing and technology partnership
aspects of Optezo’s RPAaaS platform.

Revenue cycle management (RCM) is one of the most critical business processes
for healthcare providers. Essential for bringing money into organizations, RCM
involves managing all administrative and clinical functions that contribute to
the capture, management, and collection of patient service revenue.

These functions, of course, have to be performed efficiently and accurately to
successfully manage the organization’s finances. Unfortunately, RCM is also a
very routine and repetitive process — which makes it highly prone to costly
human errors.

“RPA reduces the room for error and improves efficiency...while increasing
patient satisfaction and staying compliant”

For that reason, many healthcare providers today are turning to a
technology-enabled solution: Robotic Process Automation (RPA). Basically, RPA
allows organizations to automate repetitive and routine tasks with the help of
robotic processes, thereby increasing efficiency and reducing mistakes.


SOLVING RCM CHALLENGES WITH RPA

RCM includes a wide variety of tasks, ranging from capturing medical records to
managing payments and denials. Key RCM concerns that can be automated via RPA
include:

 * Patient registration and appointment scheduling. Phone-based patient
   interactions tend to be time-consuming and inefficient. To start, patients
   are often made to wait on hold while healthcare staff juggle multiple
   priorities. Once connected, patients have to share significant personal
   information, opening the door to typos, misspellings, and other errors for
   the person taking down the information on the receiving end. RPA bots solve
   this problem by automating the process, verifying information on the go to
   increase accuracy and speed up the task.
 * Insurance verification. Before a patient's appointment, a healthcare provider
   must verify the patient's insurance coverage. Done manually, this process can
   be incredibly time-consuming and prone to errors, as it involves typing
   individual patient information into health record systems and checking for
   coverage. With RPA, however, the process is dramatically simplified. A robot
   is programmed to automatically verify insurance coverage by pulling patient
   information from the electronic health record (EHR) system and checking it
   against the insurance provider's database — reducing the risk of errors and
   scheduling appointments more efficiently.
 * Claims processing. Healthcare providers must submit claims to insurance
   providers in order to collect revenue, but this process can be lengthy and
   tedious for people tasked with the job. With RPA, a robot can be programmed
   to automatically populate claim forms using patient information from the EHR
   system before checking for errors and submitting the claim to the insurance
   provider. Automating claims processing not only saves time but also increases
   the chances of a successful claim submission by eliminating human errors.
 * Payment automation. Billing and receiving payment from patients with paper
   invoices and handwritten checks can be a fraught process. After all, checks
   can be misdated or misdeposited, and snail mail letters lost. To prevent such
   issues, healthcare providers can use RPA to convert paper correspondences to
   electronic documents and processes. This can reduce paperwork and eliminate
   check posting errors.
 * Compliance. The healthcare industry is highly regulated, with many federal,
   state, and local laws that must be followed to the letter. RPA makes
   compliance simple with the use of robots, which can be programmed to follow
   established guidelines and regulations, ranging from the federal Health
   Insurance Portability and Accountability Act (HIPAA) to local rules. By
   ensuring that all claims are processed correctly and in compliance with
   industry standards, RPA can help reduce the risk of denied claims and
   penalties for non-compliance.
 * Patient satisfaction. Delayed or inaccurate billing results in unhappy
   patients. RPA can help to improve patient satisfaction by providing more
   accurate and timely information about bills and payments. For example, RPA
   can be used to automatically send patients an electronic bill — or even a
   text message or email — immediately after a medical appointment. RPA can also
   follow up on a timely manner on unpaid bills. This can help reduce confusion
   and frustration for patients, improving their overall experience with the
   healthcare provider.
 * Cost management. RPA can help healthcare providers reduce costs associated
   with the RCM process. By automating routine tasks, healthcare providers can
   reduce the need for manual labor, lowering overhead costs. Additionally, due
   to increased accuracy, RPA can reduce the number of denied claims, which can
   lead to a significant reduction in the labor required for appeals.

RPA can be a powerful tool for healthcare providers looking to improve their RCM
processes. By automating repetitive and routine tasks, RPA reduces the room for
error and improves efficiency — all while increasing patient satisfaction and
staying compliant with healthcare regulations.

Optezo’s End-to-End RPA Services offer everything healthcare organizations need
to successfully automate RCM processes. Curious what Optezo can do for your
organization? Get in touch with us today to learn how we can help you realize
the benefits of enterprise automation.


ABOUT OPTEZO

Our goal at Optezo is to help great companies quickly realize the value of
enterprise automation using RPA.

That's why we built Optezo to provide End-to-End Robotic Process Automation
Services. Our vision is to bring you the benefits of RPA with a tightly defined
playbook. Everything you need to successfully build an RPA program is included -
strategy, implementation, support - or our All-in-One RPA as a Service.

Optezo eliminates the complexity, headaches and hassles of RPA so you can spend
time on what's important.

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