Creating a sustainable digital workforce for hospitals using RPA.pdf

CREATING A SUSTAINABLE DIGITAL WORKFORCE
FOR HOSPITALS USING RPA
www.billingparadise.com

Resource management and its funding are
managed by RCM directors and CFOs is a
complex endeavor. The running of smooth RCM
operations defines the performance of the
hospital, health system, and clinical group,
however, there are certain drawbacks when it
comes to hiring more staff for the same RCM
process and maintaining them financially as most
RCM experts do not have the right certification
and experience to handle your particular
specialty.
A combination of robotic process automation
(RPA) and human staff can create a sustainable
workforce.
INTRODUCTION

RCM directors and CFOs worrying about too much
patient volume and whether or not RPA bots can fulfill
these tasks successfully without no error are still
skeptical among many healthcare leaders. We have
done extensive research and identified a sustainable
digital workforce for hospitals using robotic process
automation (RPA).
HYBRID OPERATIONS USING RPA
RPA bots are a sustainable solution, as a digital
workforce many hospitals, and health systems have
implemented and reaped the endless benefits it has
to offer. The reason why a hybrid model with few
RCM human staff and RPA bots programmed to
complete a respective task in RCM is needed is that
RPA bots need to be monitored once a week or
month depending upon the operational structure and
data volumes.

It is not because RPA bots can cause errors, it is because the tasks
performed by the bots need to be reflected from the management
standpoint to measure efficiency.
CREATING SPACE FOR HIGH-VALUE TASKS
While RPA bots are suited to function on tiring, tedious, and time-
consuming repetitive tasks it is only obvious that the utilization of human
staff or FTEs will be reduced. This creates an environment for the human
staff to concentrate on fixing operational gaps, unattended workflows,
and other manual paper document consolidation.
The reason to emphasize this is that many insurance companies do not
send information through ERA. Correspondence, additional information
letters, and provider-related issues all are documented and mailed out
by insurance companies that reached your mailroom and are constantly
forgotten to be worked.

We have come across various surgical groups that have lost a minimum of $80K work surgical
claims, just because the surgical notes or patient history was needed and was not provided in
a timely manner. Robotic process automation (RPA) has covered all the repetitive data entry,
verification, and filing tasks, and healthcare CFOs and RCM directors must utilize human staff
in these areas so that higher percentages of unattended and unpaid claims can be paid.
TARGETING SUCCESSFUL PATIENT CARE
Now that RPA has got the manual repetitive tasks,
human staff can now have the upper hand to understand
patient health plans, policies, and covered services. As
robotic process automation (RPA) bot’s eligibility and
benefits verification sort the patients according to their
plan and the covered services and limitations human
staff can now understand the medical necessity of the
treatment to be provided to the patient if they do not
have covered benefits for the particular service
provided by your doctors.

Your staff or FTEs can then inform the patient either during their visits or through
electronic modes to request their health plan to change the coverage for a
particular service rendered by your physician. Thus increasing return patient visits
that will be payable by their health plan instead of moving to another provider that
has more benefits due to network participation or incentive programs.
NON-STOP RCM OPERATIONS WITH RPA
There comes a time in a staff’s life they need to take time off from work or the
holidays are right around the corner and these FTEs would like to extend their
vacation time. It is in times like these that robotic process automation comes in
handy. RPA bots can cover for human staff as long as they can. This eliminates
unnecessary quarrels between staff of covering for each other’s work and planning
their vacation that a few staff remain and some take off. Management staff such as
CFOs and RCM directors can solely rely on RPA bots during these times and need
not get stressed out to hire temporary staff.

REPORTING AND ANALYTICS
Reporting and analytics are used constantly in healthcare organizations. Providing reports
and analysis on a daily basis would be a hectic process, but RPA bots have simplified
obtaining these data which has resulted in more clarity of RCM operations.
COLLECTION REPORTS
Payments from insurance companies are received almost
every day. Keeping track of payments VS write-offs is a
crucial part when it comes to managing the revenue
cycle. Robotic process automation(RPA) can provide
daily collection reports from the data collected from
both payment posting processes and manual EOBs. This
reduces confusion in preparing monthly or yearly
collection reports.

DENIAL REPORTS
RPA denial management bots provide comprehensive denial
reports which inform your clinic/ hospital on the dangers of
crossing industry-standard denial percentages and allow you
to rectify future and or major denials which affect constant
revenue loss. Practice managers and CFOs can download or
present these reports by the pictorial and graph
representation of the denial data.
AGING AND AR REPORT
Following up on AR is missed by most traditional follow-up methods. AR aging reports are
derived by RPA bots on a daily basis according to the AR buckets 30,60,120+ are clearly
available to target your priorities based upon days and dollar values. This will decrease
uncollectible each month allowing your clinic/hospital to maintain revenue targets.

LOST REVENUE ANALYSIS
Balances that are deemed as not collectibles are usually written off. To avoid this RPA bots
can easily provide you with a detailed report of 6+ months of revenue loss which you can
compare with the present month and previous year’s revenue to identify the potential leaks
and revenue losses. Comparative analysis of these months will be delivered automatically to
your billing manager every month.

MANAGEMENT REPORTS
RPA bots have eased hospital administration and practice
managers to generate resource-related reports on check-
in times, utilization hours, and time study on a particular
process.
All these are available through robotic process automation
bots, it allows your higher-level management to keep an
eye on how smooth and efficient the virtual RCM process
runs.
Having said all these sustainable digital workforces proven
references at the end of the implementation robotic
process automation is unique for every single healthcare
organization and the difference lies in patient volumes,
operational strategies, workflows, RCM teams, etc.

To identify the best-suited RPA technology for your hospital or medical group,
BillingParadise and our team of RPA and RCM experts strive to educative RCM
directors and CFOs about the implications and the ways of implementing RPA. If
you are one of the decision-making management professionals schedule a free
consultation with our RCM and RPA experts to learn more!

CONTACT US
+1 888-571-9069
PHONE NUMBER
inquiries@billingparadise.com
EMAIL ADDRESS
WEBSITE

Creating a sustainable digital workforce for hospitals using RPA.pdf

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