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RPA and taking your net 30 collections to net 25, increasing your cash position in uncertain times.

If you are a doctor or have worked in health care, you are likely all too familiar with RCM, revenue cycle management.  It’s the painful but necessary process of claims processing, payment and revenue generation.  Of course, it is far more intricate than just sending bills out randomly or making calls to insurance companies and patients.  What most people in health care realize is that RCM is really about the patient.  It’s how you get the most cost-effective treatment that works for the patient.  It also reduces your denials and increases revenue….  Below are the general steps in revenue cycle management, and more specifically how RPA can expedite this process.

♦   Patient registration
♦   Insurance verification
♦  Encounter
♦  Medical transcription
♦  Medical coding
♦  Charge entry
♦  Charge transmission
♦  AR calling
♦  Denial management
♦  Payment posting

For the purposes of this article, let’s look at patient scheduling and registration.  I know coding is the bane of all existence, but I would like to save that for another day (and likely a video demonstration).  Below is an idea of what patient scheduling processes look like:

Patient Access (the start of all journeys)



Pre-Registration (Oh the oodles of paperwork) Demographic Information
Procedures Verify Insurance
Insurance Verification and Benefits Verify Authorization Info
Appointment reminder calls (I want a calendar invite) Advanced Beneficiary notice
Authorization Denial
Financial counseling
Collect Co-Pay

If we take something as simple as appointment reminder calls, or emails, the process for automation should be quite simple.

♦    Receive call or digital appointment and confirm issue for visit
♦    Collect contact details
♦    Select open time based on calendar
♦    Confirm benefits and registration procedure prior to visit
♦    Enter information captured into system from call

There are many softwares that do most of these processes, but being a recent customer of a doctor, I can tell you there are some deficiencies in the process that could be automated or made to create a better customer experience. For RPA, looking at the collection of details and taking the information filled out, and distributing it to the appropriate systems, will enhance the experience, and reduce the amount of typing, and form filling out that your customer has to do. Further, it will reduce the overall error rate based on incomplete forms. Further, upon receiving the email and text details from your customer, one of the questions that should be asked is would they like to have a calendar invite sent? Most of us with handheld devices will appreciate this, and not a single doctor I have seen in the last 4 years does this.

Automation of these processes using RPA is quite simple as they are repetitive, specifically the capture of the information customers provide. This will speed up the registration process and in turn will give you happier patients, with more accurate information. Further, the accurate information given will reduce the issues from a coding and error with customer perspective, giving you an opportunity to reduce overall payment capture times.