“Automation Technology can solve everything!” This isn’t true! As a matter of fact, automation technology cannot solve everything, but can enhance revenue cycle management services with the help of its innovative technical features. An increasing number of healthcare professionals also agree that automation technology did improve the process of revenue cycle management.
In a recent survey, many healthcare professionals and leaders revealed their opinion that revenue cycle management services are the only main healthcare areas which require innovation. But why is the question? RCM is considered to be resource-intensive and not easily scalable for large organizations.
Instead of spending more hours at a problem, often at an expense of patient experience, healthcare professionals are seeking for smarter, intellectual and cost-effective solutions.
Why do Revenue Cycle Management Services seek Innovation?
- Fortunately, automation technologies like AI easily fits into the revenue cycle management. It is:
- Resource-intensive: It means automation offers significant savings potential
- Transaction-heavy: It means unlike retail, RCM involves multiple customer transactions to receive payments-from initial scheduling to submitting a clean claim.
- It’s also overly complex and manual, but mostly based on repetitive steps and clear rules.
- Automation is especially best at handling tasks like coding and following revenue cycle management process.
- Certain part of the patient revenue cycle management involves manual and repetitive tasks which can potentially be automated.
- In a survey conducted earlier, healthcare professionals and leaders identified that coding, billing, accounts receivable, and data sharing or interoperability are the main challenges that can be addressed with automation technology.
- It also drives attention towards patient experience and customer service and is hence considered as another driver of RCM innovation.
- To create a patient centric environment, hospital staff must concentrate on patient care and pay attention towards patients.
- Automation technology also has the ability to reduce repetitive tasks and the manual works by redirecting the workers to other highly valuable tasks.
- Healthcare professionals show interest towards two automation technologies. They are: Robotic Automation Process and Artificial Intelligence.
Robotic Process Automation in Revenue Cycle Management services:
- In a survey conducted in 2019 by Healthcare Financial Management Association, almost 15% of healthcare professionals indicated that they have planned to invest in Robotic Automation Process.
- What is this automation technology and what are its potential applications in revenue cycle? And how does it help revenue cycle management services to progress through profits?
- Robotic Process Automation is nothing but the use of specialized computer programs called Robots. They are experts in automating the repeated processes.
- These robots are particularly designed to handle straightforward, repetitive, rules-based tasks and perform them the same way every time with less errors.
- Of course, RPA will not replace human problem solving but it definitely strives to reach that problem solving point.
- Robots can also act as virtual helpers, allowing human workers to offload repetitive tasks where analysis or intervention becomes unnecessary.
Benefits of RPA:
- Robotic Process Automation is ideal for the tasks that are not complicated but consume time.
- This process leaves the humans stress-free so that they can engage in more value added patient centric work.
- Robots can work 24/7 and 365 days a year with no requirement of breaks. They can also perform tasks approximately 5 to 20 times faster than humans.
- RPA works to reduce human errors. After performing the repetitive tasks, even the most meticulous humans will tend to make errors at some point of time. For example, transposing a number when carrying over information.
- Humans also sometimes tend to get fatigued or bored while performing repetitive tasks. But overcoming all these, robots work without any boredom or fatigue.
- Robotic Process Automation helps to perform revenue cycle management services consistently, efficiently and effectively.
- Few potential cases of use include:
- Prior authorizations
- Insurance verification
- Claims administration
- Status inquiries and follow-ups
- Account segmentation
- Virtual assistance to RCM staff
- Robots are especially programmed to perform few specific tasks the same way every time. They don’t progress their learning skills or adapt to the smarter ways of solving or dealing with problems.
- To replace that, Artificial intelligence can provide the next level of automation.
Artificial Intelligence in RCM:
- Artificial intelligence involves the use of intelligent computer systems in order to stimulate human intelligent processes.
- These processes include learning skills, self-correction, and reasoning to reach conclusions by applying context and rules.
- AI uses algorithms that identify patterns and plan future actions to perform these actions.
- If healthcare professionals have ever used a Chatbot on a website, Alexa and Siri on their smart phones, then it’s easy to understand as they would have encountered AI.
- Most common applications of AI include machine learning, image recognition, speech recognition, natural language processing, and language translation.
Benefits of AI:
- Artificial intelligence has been well established in healthcare industry in the recent years. But, the benefit lies in early adoption stage for RCM.
- However, soon the situation will change. In a Black Book Survey in 2019, almost 88% of healthcare professionals anticipated the widespread implementation of AI in the next five years.
- Moreover, healthcare professionals are still exploring the ways to implement and improve the financial performance accompanied by patient satisfaction.
- Few potential cases of use include:
- Estimating out of pocket costs in real time
- Computer assisted coding (CAC): using natural language processing to interpret clinician notes
- Clinical documentation improvement
- Prior authorizations
- Claim status checks
- Analyzing EHR notes and clinical data to identify gaps and deficiencies
- Chatbots and Textbots to answer questions
- Scheduling (it can account for peak times, availability, resource load)
- Predicting availability of payer representatives in order to cut down on multiple calls and long hold times
- Matching patients with providers
- Artificial intelligence can work with RPA to create an end to end automation process. While RPA uses pre-programmed logic to handle the data which includes entering numbers on a form, AI creates its own logic that’s capable of handling structured data by typing freely in a Chatbot or Textbot or analyzing speech in a phone call.
- By combining RPA and AI, it’s possible to automate the entire revenue cycle management process-from the start till the end.
- One of the best examples of this combination is pre-authorization. While AI automates many processes, it doesn’t eliminate the requirement for human workers or human tasks. AI can serve to get the right information to the right person at the right time when human intervention is required.
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