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Streamlining revenue cycle management for your healthcare organization

Now more than ever, hospitals and other healthcare providers must position their personnel and data in the most efficient way to achieve full revenue capture.

In our white paper, “RPA Accelerates Healthcare Collections & Revenue Cycle Management,” we address how medical organizations can rely on Robotic Process Automation (RPA) software to improve their collections operations or RCM.

It’s no secret that the healthcare industry faces many unique pressures and challenges. Providers must stay on top of countless medical codes and numerous systems while dealing with increased regulations and stricter claims criteria by payers.

According to more than 5,000 doctors in the Practice Profitability Index – an annual study of the issues affecting the financial and operational health of physician practices across the US:

  • Over 60 percent of physicians cite declining reimbursement as the top threat to profitability
  • 64 percent spend at least one day per week on administrative tasks
  • 40 percent of doctors wish to improve their billing/accounts receivable departments

These significant operational concerns highlight the need for the improved operational speed and efficiency that process automation software can deliver.

Healthcare’s helping hand

The average healthcare system has myriad technologies and data sources that, too often, don’t interoperate effectively. Employees must fill in the gaps when those systems are unable to communicate with each other. These inefficient, manual interventions not only slow down collections and other processes, but they also increase the likelihood of human error.

With a simple script that mimics what a Patient Account Rep would do, automated process automation software, like Nintex RPA, speeds up workflows by automating the transfer of data between disparate hospital technology solutions with total accuracy.

Just in case the healthcare operations environment wasn’t complex enough, the International Classification of Diseases, Tenth Edition (ICD-10), went into effect in the U.S. on Oct. 1, 2015, increasing the number of medical codes from 13,000 to 68,000.

To say the clinical cataloging system that healthcare providers, insurance carriers, government agencies, IT professionals and others use added complexity to medical reimbursement decisions is a vast understatement. With its speed, accuracy and multi-criteria search capabilities, process automation software cuts the coding process down to a manageable size. Collections personnel can create an if/then script that reads and reacts to any codes and other RCM criteria to update or move accounts in bulk.

The complexities of healthcare also manifest themselves in organizational design: functional and business unit silos create data silos. With proper oversight, RPA software can automatically and accurately connect information from the different operational cells of a healthcare organization to boost overall efficiency. Robotic Process Automation software’s ease of use and scalability mean it can be adopted at the operations frontline.

Increased accounting speed, convenience, and manageability (i.e., no IT resource or third-party vendor required to operate) mean not only improved RCM but also reduced costs and reduced data-entry errors plus better staff allocation and morale.

There’s a reason 95 percent of independent physicians in 2015 favored outsourcing their RCM needs. It’s tough, demanding work that is not the primary focus of healthcare providers. Whether you help manage a hospital, physician group, or any other kind of healthcare organization, RPA software makes it easier to navigate the many healthcare industry hurdles.



For more information about automated solutions for healthcare organization challenges, download our white paper, “RPA Accelerates Healthcare Collections & Revenue Cycle Management.”



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