Webinar recap: nThrive, Banner and Moffitt Cancer Center explore Robotic Process Automation

By Andrew Woughter, nThrive Senior Vice President of Product Strategy | Posted: 09/04/2019

nThrive Revenue Cycle Management with Robotic Process Automation

On August 20th, I had the privilege of participating in a live webcast hosted by The Knowledge Group on how to “Optimize Health Care Revenue Cycle Operations with Robotic Process Automation.” This forward-thinking event also included health care revenue cycle management experts Michael Borge, senior director of Revenue Cycle at Banner Health and Jackie Chalarca, director of Revenue Integrity at Moffitt Cancer Center.

As Michael and Jackie appropriately noted, use of RPA can be a tremendous enabler for health care systems, especially when its use is consistent with organizational values, applied where it can have the highest impact and able to be sustained over the long haul.

Evolution of RPA

To ultimately pass these requirements, it is important to step back and consider the evolution of RPA, evaluating how it has been tested and applied in the health care revenue cycle management arena. In simple terms, RPA is all about using custom programming processes (think software robots or bots, as they’ve come to be known in common terms), giving them access to applications and data sources.

Best used for common tasks that can be replicated, bots can be trained to act as “virtual” revenue cycle management representatives, automating everything from pre-authorizations to denial management appeals, and more. Taking the rote busy work off the desks of already over-tasked revenue cycle management reps enables hospitals and health care organizations to shift resources to higher value functions.

What to consider

Like any significant process change, there are, of course, many variables to consider before embarking on RPA. The decision to build or buy is a big one, as internal organizations can quickly become overwhelmed not only in standing up RPA but maintain it over the long term.

Focusing on efficiencies that deliver the biggest bang for the buck is another, along with how RPA blends into existing workflows.

While some hesitation to automate is understandable, early adopters who already have taken the leap are realizing cost reductions in the 30-70% range. And, according to a Becker’s Hospital CFO Report, some health care organizations have increased their team’s capacity from 35% to 200%!

Applying RPA today

How is nThrive leveraging RPA technology today to boost revenue cycle management efficiency and success? Below are just a few samples of use cases. A full list of bots deployed by nThrive would be too long and detailed to include here. Some examples of the bots we have deployed to our existing clients demonstrate the effectiveness of automation to:

  • Work denials requesting medical records
  • Manage Lockbox correspondence
  • Handle Late charge automation
  • Load fee schedules
  • Manage Clearinghouse submission/retrieval
  • Perform Medicaid remit data extraction
  • Automate Eligibility research
  • Clear Billing edits

Examples currently in development include:

  • Underpayment recovery
  • Accurate Plan code selection from scanned insurance card
  • Additional Billing edits
  • Authorization submission/tracking
  • Government eligibility denial elimination

Big picture

The decision to embark on an RPA initiative is ultimately about seeking new, disruptive solutions that not only improve current processes but introduce completely new ways of mastering health care revenue cycle management. When choosing to automate, your medical organization opens the door to a higher level of innovation, enabling development of new Revenue Cycle Management models that will improve your bottom line!

Ready to take your health care organization to the next level with RPA? Email us at solutions@nThrive.com or call us at (678) 323-2500 to talk with an nThrive expert.