RPA holds enormous potential for healthcare revenue management

RPA is firmly within the future of healthcare revenue cycle, but whether it’s ready for prime time in hospitals and health systems depends on their foundation for innovation.

A recent survey shows 15% of healthcare revenue cycle leaders plan to invest in robotic process automation (RPA), up from zero a year earlier.

RPA mimics the actions of revenue cycle staff during insurance verification, prior authorization, claims administration and follow-up, and account segmentation while eliminating human error. RPA also can work on accounts 24/7 and complete tasks at a fraction of the time it takes staff to perform the same work. The impact: increased accuracy and productivity, lower labor costs and a stronger bottom line.

How will you engage revenue cycle staff in an RPA-enabled environment? As use of RPA for highly manual processes decreases the need for human intervention, healthcare revenue cycle leaders must have a plan for directing existing talent to more value-added work, such as:

  • Supporting revenue integrity—the top area of focus for revenue cycle leaders—by pairing staff with physicians and clinicians to strengthen clinical documentation and optimize billing-related workflows, such as charge capture
  • Engaging patients in financial discussions before the point of care
  • Aligning the work of these staff with efforts to elevate performance under value-based contracts

How will you measure results? It’s critical that revenue cycle leaders define the results they hope to achieve through RPA before it is implemented. They should also work with IT experts to determine whether these results are realistic—and in what timeframe they can be achieved.

Key performance improvement measures may include:

  • Increased clean claims rates
  • Decreased days in accounts receivable
  • Decreased denials related to prior authorization or benefits and eligibility
  • Operating cash flow

Read more here: Robotic Process Automation: The future of healthcare revenue cycle management

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