Revenue Cycle Challenges: Make Automation a Key Ally in 2021

2020 highlighted existing administrative hurdles and operational speed bumps across the healthcare industry. Normal challenges in the revenue cycle, like prior authorizations, claims processing, posting, and account adjudication, were magnified by reduced staffing, remote teams, and gaps in productivity. Many smaller practices and rural hospitals were not able to keep up with the demands of “dollars in the door” while struggling to meet the urgent needs of patients during the COVID-19 pandemic.

In a recent survey conducted by KLAS and the Center for Connected Medicine, top health system leaders agreed that revenue cycle management is the area with the greatest need for innovation and disruption. Predictive analytics, AI, bots, and automation were cited as the most-needed technologies to improve revenue cycle management, at a time when efficiency and effectiveness are two of the main topics in most boardrooms. Just completing revenue cycle claims status checks presents a workflow nightmare for most healthcare finance teams. Billing systems and applications are inefficient and too often rely on manual processes, like staff checking claim statuses via payor portals instead of waiting for delayed interfaced responses to maintain performance metrics. The beauty of intelligent automation is it takes the drudgery out of the manual process and allows people to get back to the value-added work they need to accomplish.

“We have reduced our work by 66%. We doubled in size, with twice as many providers, yet we are working a third of the volume we had before adding automation,” stated Brad Cox, Director of Patient Accounting at Northwestern Medicine. The beauty in applying automation to the revenue cycle is that it supports the needs of teams and departments without disrupting the larger system infrastructure. By understanding where the gaps are, and where the greatest need for human capital is being spent, it’s easy to determine the areas of greatest return.

The key to long-term viability is measuring the correct value proposition to ensure success. Don’t try to boil the ocean. It won’t take long to prove the value as ROI is achieved within six months for most projects. After seeing the results, you will quickly want to apply RPA to additional areas across the revenue cycle.

Matt Hawkins, Executive Vice President of Healthcare Strategy at Boston Software Systems, recently asked Brad Cox, Director of Patient Accounting at Northwestern Medicine, “What would you say to someone who doesn’t see RPA’s value?”

Brad replied, “I look at everything from an economic perspective. We have a limited amount of time in a day. What automation has allowed me and my team to do, is to use minimum mental space to think about rudimentary processes. If we don’t get claims out of the door, we don’t get paid. My managers spent 50% of their time just making sure the payors received the claims. Now, we are probably 5% claims status-ing on the back-end. We now spend 95% of our time on the areas that require our attention. We can review our appeals, review our denials, build better relationships with our payors, because we have the time to focus on high-value tasks.”

Why Boston Software Systems?

An RPA partner should promote consistency, workflow improvement, and savings. Automation can be a key ally to revenue cycle departments, empowering people to perform at their highest capacity, while eliminating repetitive, time-consuming, and error-laden tasks. Automation adds a layer of accuracy, efficiency, and operational excellence, making it easier to get work done. With a proven track record, most deployments are up and running in < 60 days, making this a winner in terms of 2021 digital health projects.

Want to optimize your revenue cycle health? We’d love to have a conversation with you. Put the power of Boston WorkStation® to work for your organization. Our team of revenue cycle specialists are ready to assist you with your next project.

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