RPA Opportunities for RCM
Author: Harper Dion
Posted: December 6, 2022
During a healthcare work shortage, countless agencies find themselves struggling with the balance of monotonous backend tasks while providing excellent patient care. At MHA, we connect with countless agencies in the space to optimize their efforts, overhauling every level towards success. A common issue we find is the lack of resources to deal with these essential backend tasks, and as inflation and work shortages increase, a solution is of the utmost importance.
When considering ROI, financial health, and productivity, centralization and automation of non-clinical tasks creates a unique solution for the longevity of post-acute care. Within the average agency, essential processes like RCM are already centralized but, there is still a lot of work to be done with optimization to ensure productivity and transparency.
Any task within an agency that is carried out in high volume on a set routine can be automated. In turn, reinvests caregiver time to more important tasks and reduces human error and burnout. Independent research shows that an average of 200 hours per week is spent on administrative tasks within post-acute agencies. This figure is far too high since a vast majority of post-acute professionals join the industry to prioritize patient care. This results in higher operational costs, high Days Sales Outstanding (DSO), and overall employee dissatisfaction and burnout. Automation can not only accurately complete these tasks in a timely manner, but remotivate staff as they have more time to focus on their areas of passion.
Automating RCM Tasks
- Insurance Eligibility Verification
Robotic processes automate much of the workflow review and even log into a clearinghouse, verify eligibility, and upload supporting documentation into the patient’s chart. For hospice patients, they validate the benefit period number and eliminate the most time-consuming portion of this role.
- Authorizations
One of the most time-consuming, routine tasks for your authorization coordinator is checking with payors to see if authorization has been granted. Depending on the payor, they may have to perform a 3-5 minute check daily for a week! This is where automation is effective; logging into a payor portal, searching for the patient, identifying whether an authorization has been granted, then attaching that documentation into the patients file and completing workflow as needed. They can even submit an authorization request.
- Billing and Collection Tasks
There are processes built to automatically review and submit claims, and then bring denial information into your EMR. If you work denials from a clearinghouse, use automation to bring those notes into the EMR to enable reporting.
Implementing automation within your agency happens on a sliding scale of time and cost based on the current state of your agency, and if your backend tasks are optimized to implement automation. We recommend doing an assessment ahead of time to ensure proper tasks are automated to increase both ROI and productivity. Once an assessment has been performed, MHA can create a tailored automation plan specific to your agency, saving time and motivating employees to provide top-of-the-line care.
MHA’s Director of Finance & RCM Consulting, Eddie Vetter, recently spoke in a webinar outlining the different opportunities where automation can increase satisfaction across the board.
To learn more, or schedule a consultation, visit us on the web at maxwellhca.com or contact Eddie at [email protected].