Key Strategies to Improve Revenue Cycle Processes in 2021

2020 was an especially difficult year for most rural hospitals and health systems, who lost an estimated 70 percent of their income due to delayed and deferred visits and procedures. Although billing and claims might seem like a pretty linear process, there are detours and bumps that challenge even the best revenue cycle management teams.

You shouldn’t have to spend hours each day manually checking to be sure the payers respond to every claim. Here are the highest value strategies for RPA implementation in the revenue cycle, with a proven return on investment.

Implement an Automated Workflow

The average hospital processes tens of thousands of claims each month. Revenue cycle team members spend countless hours going out to multiple portals to see which claims require follow-up. This manual system pulls people away from higher value tasks. Manual claims status checks take up to 50% of each revenue cycle team’s time. Instead of manually going through claims one by one, you can automate the workflow. One customer stated, “No response claims status checks revealed a 330% ROI in the first year. And that goes into perpetuity.” By automating claims status checks, FTEs are able to save up to fifteen minutes for each claims inquiry. By enabling employees to work at the top of their expertise, organizations increase productivity, save valuable time and resources, and boost job satisfaction scores and employee retention rates.

Automate Claims Management Tasks

Revenue cycle departments can have as many as 20 disparate data silos to navigate depending on the task. They still rely on manual data input from human workers, who navigate through the steps in payment processing. Automation removes this manual data burden, adding flexibility and adaptability. A recent example revolves around HRSA uninsured patient claims for COVID-19. The manual, lengthy process of researching coverage and entering data in multiple portals is replaced with automation, freeing up your most valuable resource (people) and recovering millions of dollars in claims in a matter of weeks. Leveraging RPA allows claims to be filed and payments to be posted, automatically updating patient accounts.

“CAMC was able to eliminate a very time consuming and costly process of manually entering data from and to disparate sources. Our workflow automation processes do exactly what we need them to do and with the added bonus of proper error checking.” – David Dickens, CAMC

Optimize Claim Denial Management

The Advisory Board states, “You’re probably leaving $22 million on the table,” by not following best practice guidelines in four key areas: denial write-offs, bad debt, cost to collect, and contract yield. Patient obligations are routinely being written off as bad debt, rather than spending the time to collect. Especially in areas like the Emergency Department (ED) where the ability of staff to keep up with increasing demands diminishes. What may seem like a few dollars here or there, can quickly add up to millions of dollars in unpaid, uncollected debt over time. Automation can sort through multiple databases and work queues, without an overwhelming manual burden on administrative staff. One of our clients saved 180 hours per month and $20 million in failed claims re-submissions, through the use of Boston WorkStation.

Here are just a few of our revenue cycle success stories:

• Recovered $2 million per year in Emergency Department billing.
• Saved 10 hours per day and $1.2 million per year by automating crossover claims processing.
• Saved 15 FTEs and $450,000 per year in claims submissions.
• Collected millions of dollars in HRSA uninsured patient claims within a matter of weeks.

Why Boston Software Systems?

With a solid “A” ranking in the “Best of KLAS 2021” RPA category, Boston Software Systems has a demonstrated history of results in revenue cycle performance – #bridgethegaps left by your current vendor or process. Boost revenue, increase productivity, and eliminate an administrative burden on human workers, with Boston Software Systems’ revenue cycle management solution.