For one health institution, Robotic Process Automation has a monthly savings of over 27,000 hours, corresponding to almost $500,000. It seems straightforward; there are necessary procedures in between that, if not completed correctly, might cause payments to be delayed. You may also lose money if there are coding mistakes, duplicate data, or missing information, which may be detrimental to your facility’s ability to remain afloat. Implementing effective automation in revenue cycle management is a critical component of your facility’s long-term growth and profitability.
The Right Time to Implement Automation
One of the most important lessons that hospital finance executives took away from COVID-19 was the need for innovation and organizational agility related to revenue cycle operations. When the government instructed employees to remain at home, the whole revenue cycle department went on vacation. The number of patients fluctuated like never before, hurting the cash flow. According to the American Hospital Association, hospitals and health systems would lose at least $323.1 billion in 2020. Some hospitals, especially those in rural areas, never fully recovered. In reality, 17 rural hospitals were forced to shut down during the first three quarters of 2020.
The healthcare companies that were able to weather the financial crisis were proactive in implementing new processes and technology. Some two years after the outbreak began, these firms have maintained their forward pace, with automated processes at the heart of their efforts. Organizations expect to modify their revenue cycle processes in response to altering dynamics brought about by the pandemic, according to 75% of respondents. Automation and continuous work-from-home agreements account for a significant portion of this trend. Revenue cycle management professionals are well aware that robust automation solutions strengthen their revenue cycle operation, allowing them to limit the effect of interruptions on their workforce and the bottom line.
Pandemics Cost Money, but Revenue Cycle Automation Can Help
Healthcare firms often begin by automating individual business operations regarding revenue cycle. In almost half of the cases, billing modifications are automated, and claim status is automated in nearly half. However, artificial intelligence and machine learning may have a considerably more significant influence on the total revenue cycle, resulting in reduced costs and improved revenue integrity when used appropriately. In the following sections, we will discuss some methods in which hospital finance directors may employ artificial intelligence-driven revenue cycle automation to mitigate the economic effect of COVID-19 both now and in the future.
A core revenue cycle team must be built and maintained.
When patient numbers decline, the last thing any medical finance executive wants to do is recruit competent revenue cycle workers only to fire them when patient counts rise again. Although this was the situation for many firms during the epidemic’s early stages, the failure to fund overhead staff costs resulted from the fickle nature of claim volumes. After being placed on leave or laid off, many brilliant people could find employment elsewhere, owing to the plethora of options provided by remote working. Organizations are now seeking strategies to recruit and retain top people while keeping an eye on work demands in their operations. Again, automation may be of assistance.
This approach, for example, may help minimize burnout associated with repeated, routine revenue cycle activities. The technology only tackles instances with a high level of assurance in completion. Automation may also help mitigate the difficulties associated with unanticipated increases in patient load. Volume-based pricing models from vendors enable enterprises to scale up and down as required. Finally, it provides more flexibility regarding when and how individuals work, which is a plus. With automation, firms may create a set of job queues that are always completed, regardless of remote employees’ difficulties.
Keep labor expenses under control.
Labor costs are a significant component of many hospitals’ total operating expenditures. A mid-sized health system may have between 2,500 and 3,000 employees throughout the revenue-generating cycle. Artificial intelligence-driven automation can take over some of these individuals’ jobs, allowing firms to control labor expenses better. A revenue cycle automation system could manage the workload of 19 full-time workers operating at their peak efficiency.
Increase the effectiveness of talent redeployment
Organizations may move the attention of their revenue cycle employees to more technical rejections and claims by automating the process of generating them. It is because they see fewer claims overall. The ones they handle are often more difficult, resulting in more value for their business. They may also concentrate on enhancing the financial experience of the patient. When implemented appropriately, automation may assist firms in elevating the character of the task on which personnel concentrates. They will be able to concentrate on more sophisticated duties and responsibilities that will provide them with more challenging and exciting positions within their companies. Those in charge of the revenue cycle might invest in developing more specialized and competent personnel.
Increase the consistency of income
It is possible to forecast rejections and automatically classify claims based on clinical notes provided by physicians thanks to artificial intelligence-driven automation. The capacity to anticipate — and avert — rejections is significant. Specific organizations have reported increasing rejections as payers scrutinized claims filed during the epidemic’s early stages. But, again, it is a result of constantly changing payer restrictions. Aside from that, registration staff members continue to gather information from patients who are new to the healthcare system and just seeking a COVID-19 vaccination or are hospitalized due to COVID-19. The possibility of data inaccuracies and omissions increases with each new patient added to the system. The importance of automation and predictive denial avoidance cannot be overstated.
Automation isn’t only for big hospitals.
Organizations with excellent net patient revenue are statistically far more likely to have automated revenue cycle operations than those with lower net patient revenue. Revenue cycle automation is used by 83 percent of firms that produce more than $10 billion in net sales every year. Only 36 percent of firms with annual revenues of less than $500 million in net profit revenue use it. These findings suggest that smaller hospitals have an opportunity to benefit from automation to improve revenue integrity and cash flow.
The following are some recommendations for more minor medical centers to consider:
- Identify how automation might benefit your particular firm. Determine which procedures can be made more efficient via automation, no matter how many people are involved. Is it possible that a task might benefit from a standardized, consistent approach? Is it time-consuming, and does it provide a high return on investment?
- It is simpler to begin with automating basic processes and then go to bigger, more complicated jobs in many cases. Insist on seeing a roadmap for how your solution provider intends to increase efforts throughout the revenue cycle.
- Is there a problem with consistency, productivity, or accuracy among your Rev cycle employees? They may feel stressed because they’re being tugged in too many ways.
- Smaller systems often assume they are too tiny to centralize, although they believe it would be beneficial. By combining your procedures, automation may aid in consolidating information.
- When the present cost of automation is not entirely realized because it is shared among departments or team members, it may be challenging to get buy-in for the initiative in smaller firms. Collect all relevant data to demonstrate the amount of time spent on the work across various departments or employees. Then point out a problem area that needs to be addressed. Create a plan for how staff could be redirected to this problem area and how this would lead to increased revenue.
- After implementing automation, working with your team will allow you to reallocate time and resources to more significant tasks. Let automation take care of the plethora of the same data procedures using valuable human resources.