Automation Provides a Rapid ROI to Common Healthcare Finance Processes

Robotic Process Automation (RPA) empowers healthcare organizations by enabling them to scale common finance initiatives with a proven ROI and minimum investment. There’s no wonder that growing numbers of Chief Financial Officers (CFOs) are automating financial processes. This allows finance teams to refocus time and energy on tasks that require human intervention, while offloading mind-numbing, tedious ones to machines. What are the majority of CFOs automating? Let’s take a look:

Invoice Processing

Invoicing and payments are one of the top four challenges facing healthcare today. In addition to providing greater efficiency, healthcare departments that automate invoice processing tasks reduce errors by 90%, using only 10% of human effort to review or handle the exceptions. By offloading invoice processing to a digital workforce, or machines, employees stop wasting time on repetitive, time-consuming tasks, and can focus on communicative ones that require people skills. Unlike human data entry clerks, machines never get bored, tired, or distracted. They work 24/7/365 without breaks and can process hundreds of invoices in just minutes for pennies per transaction. By automating invoice processing, CFOs can quickly see real-time snapshots of account payables to aid in faster decision-making. Data breaches and compliance risks, which are magnified by humans, are minimized by machines, while employee productivity and satisfaction scores are boosted by 85%.

Insurance Verification and Benefits Eligibility

With hospital margins waning, it has become more important than ever to avoid the cost of working (and re-working) denied claims. It’s important to know if a patient is covered by insurance before services are rendered. Eligibility describes whether the patient is eligible for services and if those services are covered by the payer and plan. Verification of benefits allows you to go deeper and find out exactly to what extent services are covered for the patient. Both largely manual processes are very labor intensive, with revenue cycle teams manually checking and rechecking numerous payer portals and websites for each patient. With as many as 18 different portals for insurance verification, it’s easy to see how human teams can become overwhelmed. A 2021 healthcare research study showed that 59% of health systems use RPA for eligibility verification, making this one of the most common processes CFOs are automating.

Prior Authorization

This largely manual process prohibits timely patient care, delays needed medications and treatments, and when time is converted to dollars, costs providers between $23-$31 billion each year (yes, billions).

Pre-authorization is required for most non-emergency medical procedures, treatment plans, medications, and services. According to a 2021 CAQH report, providers could save 16+ minutes per authorization with an automated process, which takes a little less than a minute. That’s a savings of two working days a week. RPA-enabled prior authorization has proven results. Not only can the task move faster, automation eliminates up to 98% of errors, which improves re-work queues, denial, and collection rates. And at a time when staffing shortages are high, and hospitals are struggling to meet financial burdens, automating this process addresses time, efficiency, and financial burden with a clear solution.

Claims Status Checks

Claims status checks, or manual inquiries from a provider to a health plan to check the status of an impending claim, is complicated and tedious. When a provider contacts a payer to check a claim status, it takes an average of 14 minutes and costs the provider roughly $7.00. By the time a claim reaches a denied status, the provider has lost at least two weeks of valuable time. Considering that the time between claims submission and payment can be as long as four weeks, processing delays are costly. Do the math on an average employee working a 40-hour work week and it’s easy to understand that humans can only perform so many claims status checks each week. By automating the manual process, one “bot” or machine can check claims statuses in one-fourth of the time, eliminating 98% of errors. By automating this manual, tedious process, our customers have realized an average ROI of 330% within the first 6 months.

Why Boston Software Systems?

There are a lot of RPA vendors out there, and more entering this competitive market on a daily basis. No other vendor has a healthcare-only focus with 35 years of proven success in the field. Boston Software Systems receives daily, consistent, 5-star support reviews. Our demonstrated leadership, outstanding performance, and successful technology partnerships are unparalleled. Give us a call. We look forward to automating your healthcare finance challenges in 2023, making it easier for you to focus on patients, instead of paperwork.

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