How RPA Can Boost Primary Claims Filing for Your Eye Care Clinic

Around 12 million people over the age of 40 in the United States have vision impairment, and approximately 6.8% of children under 18 have a diagnosed vision condition. As a result, eye clinics provide a critical service to those struggling with vision problems. 

However, many Eye Care processes are still sluggish and manual, causing unnecessary delays and friction. In other words, the Eye Care industry is a prime candidate for automation disruption. With this in mind, let's dive into how robotic process automation (RPA) can boost the primary claims filing for your eye clinic. 

RPA for Primary Claims Filing in Eye Care

A medical claim refers to the bill that the eye clinic (healthcare provider) submits to a patient's insurance provider. This bill contains various crucial details, like medical codes that describe the care administered to the patient. These codes may describe a diagnosis, procedure, medical supplies, pharmaceuticals, and more. The medical claims file also contains essential details like the attending physician's NPI number, charge for the service, date of service, National Drug Code (if applicable), etc. 

RPA can help combat many issues involved in manual claims filing, including lack of consistency, poor data integration, erroneous data, and the heavy labor burden. In addition, claims filing is an incredibly time-consuming process when done manually, taking Eye Care back-office workers away from more critical tasks. 

With this in mind, here are some of the specific tasks RPA can handle in claims filing and processing:

  • Storing and managing data: RPA systems can efficiently copy and paste or transfer data between applications to ensure all patient details are consistent and up to date. This is particularly critical in Eye Care, where legacy systems are often inflexible and struggle to keep up with the demands of modern healthcare environments. RPA tools are system agnostic and can handle data transfer between systems, regardless of that system's particular quirks. 
  • Automated billing: RPA bots can auto-fill medical bills by extracting relevant details from disparate systems. This provides consistency and reduces the chance of rejections or back-and-forth clarifications with the insurance company.  
  • Verification and validation: Automation bots can validate data, cross-checking it across all available patient records to ensure outdated or erroneous details don't make it into the primary claims bill. 
  • Automated filing: RPA bots can log in to Insurance portals, enter claim data and file the claim, all without human input. 
  • Reporting and audit trails: RPA-powered automation can generate reports and create summary logs for audit trails and better in-house decision-making. 

Today, Eye Care companies have a wealth of choices when it comes to highly effective, cost-cutting, and time-saving claims filing RPA bots. Finding the bots that meet your specific business need has never been more straightforward. 

When you get down to it, RPA bots cut costs, improve efficiency, and, most importantly, improve patient outcomes. For example, you can ensure a smoother patient journey by speeding up the claims filing process and eliminating costly errors. And this is especially important in healthcare, where delays can exacerbate anxieties and impact people's livelihoods.

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Published On:

April 28, 2023

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