Artificial Intelligence & Robotic Process Automation
Robotic process automation (RPA) has been hailed as a revolutionary technology that will automate low-value, high-volume tasks across the business world, from clerical to complex cognitive work.
What is RPA? It’s a form of advanced automation where a software robot can perform tasks and interact with systems just like a human employee would. The “bots” use natural language processing and advanced analytics to read and understand what the users are asking for and take actions within applications, moving from system to system if necessary in order to get things done within enterprises or external systems.
RPA is generally best at automating highly repetitive tasks that follow precise steps, such as processing insurance claims or mortgage paperwork. Where RPA may fall short today is in areas requiring more sophisticated cognitive skills, such as making business decisions based on unstructured data like reviewing legal documents for compliance purposes.
The promise of RPA is to free up humans from the menial chores of the present paper-based world to benefit businesses or just go home sooner because they are not stuck in back-office traffic jams.
RPA - Future of Health Services Revenue Cycle Management
Human resources are valuable to any company because they provide stability and consistency. With RPA, you can streamline your human resource processes while eliminating potential errors in key data that cause major Magazine billing problems for organizations every day. RPM offers an easy way of completing tasks that would typically take several hours with just minutes spent on them; this means better efficiency and faster cycle times than ever before!
Insurance verification is some of the RCM functions that can be streamlined using RPA:
- Preauthorization.
- Insurance Verification.
- claim to present.
- Patient Billing.
- account division.
RPA is an innovative program that automates tasks to save time and manual input. The automated process checks the information from multiple data sources, then moves it all into one place for you!
Why Clinics are moving to make RPA an integral part of RCM
RPA is the subset of Artificial Intelligence that helps to perform tasks in an automated way. Robotics, chatbots, and voice-based user interfaces are some forms of RPA. The most common example in the healthcare industry is when a customer calls up for information on any medical condition or treatment, he is usually asked his name and phone number by the system.
Once this information has been provided it fetches all the relevant records associated with him from all touchpoints like hospital/pharmacy visits; past medical history; insurance claims etc.
RPA has the potential to transform patient care. It can bring about a sea change in how claims are processed, freeing up time for doctors and nurses to focus on patients’ needs while also reducing the cost of compliance associated with insurance/patient portals.
The use of RPA does reduce healthcare costs by increasing efficiency and accuracy in the aforementioned manual tasks. Furthermore, it helps prevent errors that can cause serious consequences not only for the patient but also for the hospital as a whole. There is a growing realization that robotic process automation could be critical to health organizations’ ability to execute on their strategies to achieve higher productivity resulting from digitization, improving customer satisfaction, and enhancing transparency.
Automation: No response claims, payment postings, and free entry
Robotic process automation is being increasingly adopted in the financial services and retail industries, as well. Healthcare companies have been slower to adopt it because they worry about replacing employees or cutting costs by doing so; however, this technology also carries some benefits like increased efficiency which could lead them down that same path eventually!
HealthQuest RCM, a company that has been leading the healthcare industry in using robotics for years now and specializes in providing cost-saving solutions with their advanced technology. We pride ourselves on being innovative by automating repetitive tasks to reduce cycle times as well as improving efficiency through automation which also helps cut labor costs too!
HealthQuest RCM uses robots to perform repetitive, rule-based tasks that would normally take staff members an excessive amount of time. The speed with which these bots can complete work makes them perfect for higher volumes on a fractional basis compared with full human employees who may not be as quick on their feet or efficient when it comes down to simply completing things quickly enough due solely out being humans!
For our customers, robotic process automation increases claim productivity. The RPA’s power to investigate a claim that a payer has been filled out but no answer has been received is demonstrated in the following scenario. Take note of the similarities between human and robot workflows.
Make An Appointment
Have any Question?
Book an appointment
Have care Requirement?
Call the hospital
No Response claims using AI-RPA
For critical strategic clients, HealthQuest RCM created bots to manage “no payment” or “no response” claims. HealthQuest RCM has deployed bots to query and act on “no pay” or “no response” claims that claim the organization of work has improved for automated thorough data retrieval and follow-up, based on customer-specific requirements for the time the payer pursues the claim.
Automated processes by bots include
- From the practice management system, download the report due.
- Bot filters reports/claims that fulfill particular age and response parameters.
- The bot payer logs into portals and obtains claim status for the given claim using filtered inventory.
- For A/R experts to take further action, the claim status is updated in the HealthQuest RCM internal workflow and Analytics application database.
Payment posting using AI-RPA
HealthQuest RCM uses robots to improve internal billing efficiencies for about 30 customers by automating repetitive tasks. The company’s “attended bots” are triggered by staff members who need assistance, while unattended ones complete the scripts automatically with no human interference – allowing employees to focus on higher-value activities such as processing payments more quickly and accurately than ever before!
The processes automated by attended bots included
- Extract ERA (Electronic Remittance Advice) information from various clearinghouses and third-party payor websites, download it into the billing platform and parse it.
- Open the ERA files you downloaded and finish your electronic posting.
- Validate and verify for mistakes when payment posting is complete.
- Multiple HealthQuest RCM teams have used it across multiple platforms.
The implementation of automated charge entry at HealthQuest RCM has been vital in streamlining the revenue cycle process. This is due to practices and groups still using paper superbills, which must now be digitized before being entered into their system for processing; this creates an error rate that can’t always be controlled by humans alone.
The processes automated by the bots included
- The processes automated by the bots included
- The superbills were downloaded by bots.
- Coders went over the superbills and put the procedures and diagnoses into a proprietary program.
- The bot used the information entered in the application to populate practice management systems.
- The coder/biller double-checked the information before submitting charges.
Results:
- Productivity and turnaround times have improved.
- Data entry error rate was reduced, and quality audits increased efficiency.
- FTE has been decreased by 40%.
HealthQuest RCM was able to reduce the time it took to acquire eligibility verification and benefit determination, process claims, obtain claim status, process payments, and manage denials by implementing RPA.
- By using BOT technology, HealthQuest RCM reduced the manual effort involved in checking no-response claims by about 23%.
- HealthQuest RCM was able to relieve physicians of an administrative burden by managing credentialing and provider enrollment tasks. This means that they are no longer responsible for the arduous process, which is a great relief!
- HealthQuest RCM achieved an ROI of 75% using BOTS. The system also managed to license and Sanction checks, part of their task for credentialing patients with the necessary credentials needed in order to receive care from the hospital’s service provider network using this new technology!
- This automation frees up physician offices to focus on patient care instead of the paperwork that comes with billing for medical services rendered.
How Is HealthQuest RCS Utilizing RPA Processes for its Current RCM Clients
At HealthQuest RCS, we have developed RPA technology to help our clients use their staff more efficiently and cut costs from their RCM. RPA automated repetitive, high-volume, rule-based processes. This allows your company the ability to decrease your revenue cycle time, improve efficiency, reduce errors, streamline operations, lower overhead, and increase profits.
Billing-Analytics We understands the importance of accurate reporting and analytics. This is an awesome way to effectively measure success. HealthQuest RCS offers the ability to use RPA to create custom dashboards that reflect your organization’s most important metrics – KPIs.
At HealthQuest RCS, we offer Claims Monitoring with Waystar. When your company uses these tools, you can set a time frame for your claim submissions. For example, if you set the time frame at 30 days, the system will automatically ping the payer for status 30 days after the claim is submitted. The payer will then send the status back to HealthQuest RCS to let your office know where in the cycle this claim is – ie In Process, Pad, or Denied.
With our technology, an employee does not need to work with the follow up on claims. They occur automatically and can be easily checked and overseen by staff. The accounts receivable team can see the status of claims at a glance and Identify when one needs their direct attention. This technology allows organizations that use HealthQuest RCS to file claims more efficiently and speed up the payment process.
When I look at Healthquest I look at them as Operators, we don’t look at them as consultants. There was always a conversation about why did we outsource. Unfortunately, we have to change several software and applications in past but selecting the right revenue cycle partner is like security assured income.”
“We are glad to meet partners, not a third-party vendor who knows out-of-network billing with top insurances. Healthquest creates a better environment for the sales reps and we will be able to grow our volume and revenue and achieve a better outcome.”
We never had an idea to validate genetic services in our chain of labs special thanks for HealthquestRCM Validation-Molecular and Revenue Cycle team we are delighted with your services and knowledge