Leverage robotic process automation to automate billing edits and work denials

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Did you know many hospitals and healthcare organizations have increased their team capacity from 35 percent to 200 percent with Robotic Process Automation (RPA)? With this powerful technology, organizations enable their resources to focus on higher-priority, problem-solving tasks.

In normal business circumstances, effective automation tools are must-haves to ensure timely and accurate medical billing. But we’re in a new normal – coping with revenue loss because of COVID-19 while at the same time identifying immediate opportunities for cash acceleration.

Social distancing due to COVID-19 has forced healthcare industry leaders to rethink how work gets done. Traditional onsite employees are working remotely. Some are deployed to new roles in response to the pandemic. Now is the time to recognize these changes and reinvent processes, leveraging RPA solutions from nThrive to operate more efficiently now and in the future.

What is Robotic Process Automation?

While we are all accustomed to logging into software to get our work done, RPA can do it for us. Think of it as software programmed to log into a system and emulate a person, replicating what a human would do. For instance, a “bot,” as RPA software is typically called, can enter a username and password, access an account, trigger application programming interfaces and operate directly on the objects within the system to parse information and complete work processes including:

  • Low value work that may be eliminated and/or avoided
  • Processes capable of being partially or completely automated
  • High volume tasks where automation allows doing more with less

RPA can easily automate billing edits, denial management tasks and more in a manner of seconds versus minutes for human specialists, freeing your employees to work on more complex, human decision-making requirements.

How do you get started on RPA?

Because it is never a good idea to take a bad process and just do it faster, an RPA implementation should start by optimizing and assessing your existing processes. Once you’ve identified root causes of inefficiencies and deployed corrective actions, RPA can be utilized to emulate many of the clean-up tasks your staff currently does today.

Where is RPA being used in healthcare to lighten the load?

While there are many choices, common bot applications include:

  • Managing denials
  • Managing lock boxes to address and/or route correspondence
  • Handling eligibility processes
  • Submitting notifications on admissions
  • Adding claims attachments
  • Executing billing edits
  • Translating Medicare codes to standard codes
  • Automating authorization submission and tracking
  • And many more

How hard is it to deploy RPA?

That depends. If your healthcare organization decides to build your own bots, you’ll need in-house resources both to create and maintain your bots.

Partnering with an expert RPA resource like nThrive can be much more efficient, especially since we take pride in fully understanding healthcare revenue cycle management processes and we’re committed to leveraging RPA technology for the long term. At nThrive, our RPA deployment includes creating bots with a “smart architecture” based on shared knowledge that is maintained across multiple users. Should something go awry, issues can be addressed rapidly by our RPA experts to minimize downtime.

How much does RPA save?

The average labor savings from RPA is dramatic. One large, 50+ hospital that deployed bots for adjustment claims (XX7 type bill), eligibility denials and root cause (XX7 claims) eliminated between two and four FTEs per application, resulting in ROIs of as much as 583 percent! Smaller facilities can also benefit greatly for a quick win.

To learn how RPA can help your organization do more with less, visit our RPA solution page or contact nThrive


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