Medical Billing Automation: Three Powerful Use Cases

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Billing, payments, and adjustments are one of the most tedious, time consuming, painful processes in the medical industry. Patient responsibility, insurance adjustments, and multiple avenues of billing make the process extremely complicated. On top of that, most healthcare organizations are beholden to their EMR systems. Changing systems is not an option, and adding software doesn't solve the real issue: scaling billing output without hiring more people.

But advancements in automation have made the majority of the medical billing process automatable, even in the face of so many complex processes and variables. That means less human input, saving you on payroll, mistakes, and most of all, time.

What is robotic process automation?

Robotic process automation (RPA) is a fancy term for making computers do tasks without human input. RPA is essentially an army of digital workers that complete repetitive tasks, saving hundreds of work hours compared to human-driven data processing.

Automated processes can be applied to hundreds of tasks in dozens of industries. RPA is incredibly flexible programming, and can be adapted to nearly any logic-driven digital process.

Automation is picking up steam in the medical industry

Unfortunately, solving process bottlenecks in healthcare isn't as simple as just re-platforming. Migrating to another solution may create a gentler user experience for billing teams, but ultimately doesn't solve the problem of a cumbersome process and a mounting backlog of claims. Healthcare providers are tied to their claims filing processes by insurance companies as well, doubling the barrier to an improved workflow. An even further barrier is the sensitive nature of the information. Solutions have to be HIPAA-compliant because these offices deal with such sensitive personal information.

Many providers are overcoming these barriers to innovation by automating within their existing systems and processes using RPA. In fact, automation has become such a powerful option for modern healthcare companies that the number of large healthcare organizations in the UK with an automation strategy increased 40% in just the last few years.

The COVID-19 pandemic has had its own impact as well. Medical service providers took a huge hit in 2020 as new regulations started to roll out. New procedures, limits, and changes to claim adjustments can make mistakes start to pile up. Automation limits human errors and keeps your processes running smoothly.

Billing automation at work

In healthcare around the world, workloads have become impossible, staffing is more of a challenge than ever, and new software is a bandaid solution. The good news? Medical billing processes are automatable. These processes are for the most, logic-based, following strict sets of rules (albeit complicated ones), making them great candidates for automation, and freeing up billing teams to process anomalies, such as Medicare refusals and patient billing inquiries.

 

1.  Revenue Cycle Management

  • Payment tracking
  • Adjustments
  • Invoice/statement creation

Automation can make a powerful impact in revenue cycle management. Payment and adjustment tracking is extremely important, but also incredibly time consuming. With an automated billing system, payments are instantly updated and adjusted accordingly.

2.  Insurance/Claims Processing

  • Claims management
  • Applying insurance/patient responsibility

Filing insurance claims and adjustments is tedious, boring work that can be easily handled by robotic process automation. The claims process is entirely logic-based, meaning computers can easily plug information in and adjust payment details. An RPA workforce can access and scan insurance systems independently, finding EOBs and plugging that information into each individual claim.

3.  Data Validation

  • Data entry
  • Information scrubbing

Not only can automation software systematically record and process existing data, but it can also automatically scrub information from forms. Finding laborers to do these processes efficiently can be extremely difficult in the current job market, and preventing errors is almost impossible with human input. Automation eliminates both of these issues.

Automations pays off

The rewards of automating your billing process go beyond saving time and money on payment management. The more your computer system does for you, the less you rely on a physical workforce, and that creates far-reaching change. Here are four more powerful benefits of an automated billing system:

Eliminates input/data errors

Automated digital workforces operate at 99.99% efficiency, eliminating errors that result in increased costs (for both the patient and service provider). This also helps maintain a standard process across all billing platforms, keeping records consistent throughout the system.

More efficient workflow

It doesn’t need to be said that computers are more efficient than humans at repetitive digital work. Data input and processing is infinitely faster with automated billing, saving hours upon hours of time that would normally be spent punching numbers into a keyboard.

Smaller, stronger workforce

Because of its efficiency, automated billing is infinitely scalable, meaning you are free to grow your business as fast as necessary to keep up with demand. Hiring new employees to keep up with increased billing workload is no longer necessary!

Enhanced patient care/experience

Less data input and paper processing means happier, more productive employees. The time saved on billing and payments can be better spent servicing patients and answering questions for clients.


Most basic automation programs aren't powerful enough to handle the data. This is where Thoughtful excels. We are a fully customized robotic process automation design company providing concept-to-launch in less than two months and 24/7 system monitoring and management following the deployment of your automation tool.

Author

Cameron Burgard

Cameron is a Customer Solutions Manager at Thoughtful, and is closer to our customers’ processes than anyone. Together with our automation team, Cameron walks through our customers’ processes through every step and click, and ensures that no step or variable is missed on their path to a smooth, successful, and rapid automation.

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