HealthcareDeliver Superior Clinical and Enhance Patient Experiences
Managed Healthcare and Providers
As patient numbers grow, healthcare providers are challenged with managing levels of inventory, supporting digitization of patient files, optimizing appointment scheduling, and executing billing and claims processing. To help overcome these operational pain points, more and more healthcare providers are embracing RPA to alleviate these challenges and drive enhanced efficiency and growth. Healthcare is predicted to have a 36% automation potential. This means more than a third of healthcare tasks—especially managerial, back-office functions—could be automated, allowing healthcare providers to offer more direct, value-based patient care at lower costs and increased efficiency.
System Migrations, Yearly Benefit Enrollment, Complicated Benefits, Regulatory Changes, Fee Schedule Increases/Decreases, New Business creates processes too complicated to automate in a cost-effective way or not quick enough with SDLC programming or even BPM applications. This lack of efficiency and responsiveness results in massive number of claims that either need to be manually processed or allow to system automate incorrectly and adjusted retrospectively. Both approaches are expensive and can generate significant provider abrasion with related customer service and rework costs.
Rules differ with each Insurer and time is money so getting the claim submitted correctly the first time is paramount. When dealing with Medicare or Medicaid, if a claim is initially rejected, it must be adjudicated. Again, time is of the essence. In some cases, if a claim is not resolved within a specific timeframe, it cannot be paid.
Healthcare Providor – Revenue Management
Chasing down the status of claims across multiple Insurers’ systems is time consuming. Allowing a robot to check claim statuses and update them into the Provider’s system ensures that the revenue will be realized. Where the robot notes a delay, the appropriate person will be notified immediately to resolve the specific issue. The robot can continuously monitor 24X7.
A tremendous amount of paperwork needs to be completed and input into multiple systems. A robot can do the inputting in less time, with error-free results.