Electronic Health Reporter

By Brian Cafferty, vice president of RPA development, Tebra.

Robotic process automation (RPA) is a software technology that uses “bots” to replace repetitive, rule-based tasks and processes. In everyday life, people use RPA technology anytime they rely on form auto-fills, credit card payments, call center menus, or banking automation.

While the hyper-automation trend has taken root in most industries, bots are just starting to catch on in medical practices. The average practice performs many time-consuming and repetitive administrative tasks that require large amounts of data to be pulled, categorized, summarized, and reported. However, these tasks don’t require specialized knowledge. RPA can provide task automation across the organization, from front-office tasks to operational processes to patient interaction and bill payment. In addition, minimizing manual processes can reduce error rates that cost time and money.

Our customers and early adopters of RPA report that within the first three to six months of implementation, they saw improvements of 50% in operational efficiencies, 200% in claims processing speed, 30% in revenue per clinical encounter, 95% clean claims and only 2-3% claim denial rates.

Automating essential workflow

Onboarding new patients is a process you can automate while improving the patient experience. For example, a bot can provide an integrated data connection between your electronic health record (EHR) and billing platform. As patients complete the intake and insurance forms, this information is automatically entered into your billing platform.

As more patients demand convenient digital touchpoints, bots can maximize back-office efficiency with appointment scheduling. Bots can process patient appointment requests by presenting available time slots and adding selected appointments to the practice’s database. In addition, the RPA tools can assist with patient check-in, validating health plan coverage, and arranging pre-authorizations for planned procedures and treatments. For smaller practices or those with lean office staff, these automations can significantly reduce time spent on non-revenue-generating tasks.

For practices that need to migrate patient EHR data when transitioning from one practice management software to another, bots can initiate keystrokes to create a clinical note for each patient encounter to ensure the patient’s complete medical history is captured accurately.

By reducing the administrative tasks that do not require specialized knowledge or a human touchpoint, your practice staff can focus on delivering better care to improve patient outcomes and grow your practice.

Transforming revenue cycle management

Revenue cycle management is the backbone of your practice. RPA is critical to eliminating inefficiencies and streamlining your processes to transform healthcare billing. Once implemented, bots will take charge of the most error-prone part of billing to eliminate errors from human fatigue, lack of concentration, and simple mistakes, significantly reducing claim denials and their related costs.

Regarding medical billing, various insurers require information in different formats, but data arrives in a system-specific configuration depending on your EHR. Bots can standardize data for seamless and accurate information downloads, ensuring that each insurer receives the required data in the correct format for quick processing. In addition, as compliance requirements change frequently, bots are easily reprogrammed to adjust to the ever-changing landscape.

As you receive an Electronic Remittance Advice (ERA) with payment, bots can review and apply payments in the claims process. From there, it will apply payments from the patient and generate an invoice for the remaining balance. This automation eliminates costly billing errors and frees staff’s time to focus on more critical tasks. In addition, it ensures patients receive accurate statements and payment reminders to understand their payment obligations better, thus improving the collection cycle.

The greatest impact 

Large healthcare facilities regularly use RPA to increase efficiency and profitability, but small to medium-sized medical practices lag behind. For practices to remain competitive, RPA is critical to ensure workflow is accurate and efficient. When errors are eliminated, claims go through faster, resulting in improved cash flow and revenue. In addition, highly-skilled professionals are relieved of mundane tasks and paperwork. As a result, they can treat more patients, which leads to better job satisfaction and, ultimately, better patient experiences.