Charge capture and entry RPA is mainly overlooked and considered a manual process, well that is a misconception. We have researched leading surgical groups and hospitals on the current scenarios they face in capturing and entering charges, most of these healthcare organizations are facing difficulties capturing the services rendered in the charts and then making entries on their designated EHR.
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Large surgical groups and hospitals need RPA charge capture and entry, here’s why.pdf
1. Large surgical groups and hospitals
need RPA charge capture and entry,
here’s why?
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2. Introduction
Charge capture and entry is the first and foremost RCM process that
brings revenue to any surgical group or hospital. Given that robotic
process, automation is being implemented in every process of RCM and
hospital or practice administration. Charge capture and entry RPA is
mainly overlooked and considered a manual process, well that is a
misconception.
We have researched leading surgical groups and hospitals on the current
scenarios they face in capturing and entering charges, most of these
healthcare organizations are facing difficulties capturing the services
rendered in the charts and then making entries on their designated EHR.
What are charge capture and entry?
Charge capture and entry are RCM processes in which healthcare
professionals document and record their rendered services. Clinical
documentation of the services provided to the patient is then entered into the
PMS, EHR, or clearinghouse and submitted to the respective insurance
carrier for payment. With that being said, let’s learn about the complications
faced in manual charge capture and entry.
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3. What are charge capture and entry?
Lack of service level knowledge.
Failed to capture surgical medications like surgical/general anesthesia.
Not including PAs or NP’s assistance.
Unable to follow regulatory compliance.
Typographic human errors.
Huge patient volume.
Comparing CMS guidelines.
No prior audits before claim submission.
Some of the significant errors that occurred in manual charge capture and
entry are:
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After a patient has finished their surgery/treatment, the healthcare facility
continues on toward the charge capture process. Charge capture is a
significant chance for all healthcare organizations to stop revenue leakage.
According to industry standard numbers by HFMA and MGMA a sizable
healthcare facility with 189,000 unentered and failed to capture charges in
one month can lose $36 million in revenue.
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4. Dangers of inaccurate charge capture and entry pose a major threat
and affect the core operations of the surgical group or hospital such as
regular external audits for duplication or upcoding a charge. Other
dangers such as raising denials rates of which 15% is due to missing
or invalid charge data. These accuracy errors are a direct result of
overwhelming volumes and a lack of staff to perform these manual
tasks. RPA-assisted charge capture and entry minimizes these
manual staff burnouts and gives them an edge in completing these
tasks accurately and in a timely manner.
Accuracy is key when it comes to passing all edits of clearinghouses
and insurance companies, here’s where robotic process automation
comes into the picture to eradicate the burdens of manual charge
capture and entry. This results in documenting and entering the
services rendered to the patients and allows your billing department to
decrease claim denial rates and operational costs while increasing
productivity and 100% quality.
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5. The necessity for surgical groups and hospitals to implement
RPA charge capture and entry
The Center for American Progress revealed in 2019 that billing-related costs
went from 2% to 5% for conventional Medicare and Medicaid to a surprising
17% for commercial payers. One part of these expenses is the time it takes to
accommodate charges and clinical notes. Manual charge capture expects staff
to audit clinical notes from the EHR or other IT solutions and compare contrast
between them and doctor notes in the charts or surgical reports. This cycle
includes getting to an EHR or having support staff present a patient record
demand, scanning records for crucial notes, and guaranteeing that the surgical
report or chart content matches the charge.
The costs and time engaged with this cycle add up rapidly. A surgical group or
hospital with a normal of 75 weekly inpatient encounters would require 325
hours of work, also the effects on RCM KPIs, for example, DNFB and AR days.
Robotic process automation charge capture and entry technology will save time
and decrease costs, manual work burdens, and errors simultaneously.
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6. www.billingparadise.com
Charge capture implementation methods that will transform your
surgical group/hospital's RCM
Clean your scrubbing data at the most proficient spot – the front end. Usual claim
scrubbers sit at the back-end of the charge capture and entry process after this
process has been completed using RPA-assisted charge capture and entry. A front-
end RPA solution with an up-to-date data model and current, modern innovation that
can undoubtedly coordinate with your current EMR and RCM framework is the most
remarkable and accurate method for cleaning your scrubbing data. It practically
eliminates the time required for tedious charge rectification and reworks efforts.
Identify an EHR system that allows RPA to automatically correct incorrect data. An
RPA charge capture and entry audit and transmission of entered charges into your
PMS or billing software guarantees that clinical encounter data are suitably and
consistently arranged with the payer’s billing and regulatory compliance.
7. Implementing a robotic process automation solution that will be able to adapt to your EHR, PMS, or EMRs requirement.
This will permit you to get reimbursed quicker with less manual staff effort. It will likewise guarantee that you can rapidly
and effectively make or adjust rules to meet the developing necessities of your healthcare facility, eventually creating an
environment for the financial well-being of your healthcare organization.
RPA charge capture and entry rule-writing capacities are critical for your surgical group or hospital’s prosperity. Utilize an
RPA system that effectively coordinates with your current RCM workflow so you can create rules for your own particular
data arrangements in your billing software or EHR.
Lastly, the right RPA charge capture and entry technology will lessen the number of times your staff needs to deal with
claims. It gives refined choices that guarantee claims are spotless and sorts out tolerant charging data to help with
collections. This is a significant stage in every surgical group or hospital’s RCM.
Conclusion:
We understand that leaping into RPA without prior knowledge must be
complicated and the practical implications of robotic process automation RCM
tasks. The main problem with this ideology is that you do not have to set up
your complete RCM process automation but a few areas that are more crucial
to getting revenue such as charge capture and entry.
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8. Hundreds of surgical groups and hospitals are now realizing the importance of robotic process automation and are
gradually moving towards implementation.
BillingParadise is one of the RPA and healthcare IT solutions companies that has already created various RPA solutions for
dental and surgical groups. We have received feedback from their in-house RCM staff that they haven’t done the charge
capture and entry without pressure and are able to concentrate on more important core operational functions.
In the end, human intervention is mostly needed to oversee the operations rather than pressuring staff causing burnouts
and attritions, so consider this as a learning curve and discuss with our experts on the real robotic process automation
benefits.
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9. Thank You
PHONE NUMBER
+1 888-571-9069
EMAIL ADDRESS
inquiries@billingparadise.com
WEBSITE
www.bIllingparadise.com