Exploring Automation in Revenue Cycle Management

Automating your revenue cycle management processes can improve not only your healthcare facility’s financial performance, but also the patient and staff experience.

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At a time when many hospitals are experiencing revenue challenges and staff shortages, automation has risen not just as a luxury, but as a must-have resource. Automating the revenue cycle can remove tedious, repetitive tasks so providers and administrative staff can focus on more complex, strategic initiatives. Revenue Cycle Management (RCM) automation can expedite the financial journey for patients, from intake through final payment of charges.

Common challenges with RCM

The RCM process is inherently complex, with numerous interrelated and interdependent steps. According to a recent Trends in Healthcare Payments Annual Report from InstaMed, patient collections can take more than 30 days to resolve for 74% of providers — and can be even more challenging for large patient balances. Other common RCM challenges include:

  • Different payers using different rules, regulations, and submission processes
  • Security and privacy issues, including HIPAA compliance
  • Prior authorization requirements
  • Overwhelming paperwork
  • Staff shortages
  • Staff burnout due to administrative tasks

Effectively managing revenue within a healthcare facility is essential to ensuring the health of the organization. Unfortunately, outdated systems and processes can make revenue management more difficult than necessary. Automating specific RCM tasks and processes can remedy this problem, ensuring streamlined workflows and reduced administrative burdens.

The value of automating RCM

Although automation in healthcare was inevitable, the pandemic and resulting staffing and financial difficulties rapidly accelerated its adoption. There are three primary types of RCM automation:

  • Robotic process automation (RPA), which uses pre-programmed scripts to handle tedious, repetitive manual tasks such as data entry.
  • Artificial intelligence (AI), which can undertake more complex tasks, such as demographic verification and collections, and perform some predictive analytics.  
  • Machine learning (ML), which allows AI to learn new tasks beyond its initial programming.

Automating various aspects of RCM can deliver significant benefits to the RCM team in particular and the healthcare organization as a whole. For example, RCM automation can streamline the billing cycle and administrative tasks, freeing up providers and their staff for more face-to-face interactions. This can improve the patient experience and patient satisfaction, which, in turn, improves patient relations and even health outcomes through better diagnostics and a less stressful environment. RCM automation also means fewer errors and less time correcting and resubmitting denied claims, which translate to faster billing cycles and quicker payments.

The key to getting the most from RCM automation is understanding the technologies available and implementing them effectively. The best way to do that is by finding a company with RCM automation experience to partner with – like TruBridge. Visit https://www.trubridge.com/contact/ to talk with an expert or schedule a product demo.