Healthcare Revenue Cycle Management Automation Benefits

Best time for automation implementation

One of the most important lessons learned by hospital finance leaders at COVID-19 was the importance of revenue cycle operations innovation and organizational agility. When the government told staff to stay at home, the entire revenue cycle department went on leave. Patient numbers fluctuated to highs and lows without any indicators, causing cash flow problems. The American Hospital Association estimates that hospitals and health systems lost over $300 billion in 2020 alone. Some hospitals, particularly those in rural areas, never recovered completely. During the first three quarters of 2020, 17 rural hospitals were forced to close.

Healthcare organizations that survived the financial crisis were proactive in integrating new processes and technologies. Two years after the outbreak began, these companies have kept moving forward, with automated processes at the center of their efforts. According to 75% of respondents, organizations intend to adapt their revenue cycle processes in response to changing dynamics caused by the pandemic. A major chunk of this tendency can be attributed to automation and continuing work-from-home agreements. Revenue cycle management professionals understand that strong automation solutions boost their revenue cycle operations, allowing them to minimize the impact of interruptions on their workforce and the bottom line.

Build and maintain a core revenue cycle management team

When patient numbers are declining, the last thing any medical finance director wants to do is hire competent revenue cycle personnel only to lay them off when patient numbers increase again. Although this was the case for many firms in the early phases of the epidemic, the failure to cover overhead staff costs was caused by the volatile nature of claim volumes. Many outstanding people might find work elsewhere after being placed on leave or laid off, thanks to the multiplicity of alternatives given by remote working. Organizations are now looking for ways to recruit and retain top talent while also keeping a close watch on work demands in their operations. Again, automation may be useful.

This strategy, for example, may aid in reducing burnout associated with repetitive, typical revenue cycle duties. The technology only handles cases with a high level of certainty in completion. Automation may also aid in mitigating the challenges associated with unexpected increases in patient load. Vendors’ volume-based pricing structures enable organizations to scale up and down as needed. Finally, it allows for greater flexibility in terms of when and how people work, which is a benefit. Firms can use automation to construct a set of job queues that are always fulfilled, regardless of the difficulties of remote personnel.

Control labor expenses

Labor costs account for a sizable portion of many hospitals’ total operating expenses. Throughout the revenue-generating cycle, a mid-sized health system may employ between 2,500 and 3,000 people. Artificial intelligence-driven automation can take away part of these workers’ employment, allowing businesses to better control labor costs. A revenue cycle automation system could handle the task of 19 full-time employees working at maximum efficiency.

Increase the effectiveness of talent reallocation

By automating the process of generating rejects and claims, organizations can shift the focus of their revenue cycle personnel to more technical rejections and claims. This is due to the fact that they see less claims overall. The ones they handle are frequently more complex, resulting in greater value for their company. They may also focus on improving the patient’s financial experience. When used correctly, automation can help businesses improve the nature of the tasks on which their employees focus. They will be able to focus on more complicated duties and responsibilities, which will lead to more difficult and exciting positions within their organizations. Those in charge of the revenue cycle may wish to invest in the development of more specialized and skilled employees.

Strengthen the consistency of income

Thanks to artificial intelligence-driven automation, it is feasible to foresee rejections and automatically classify claims based on clinical notes provided by physicians. It is important to be able to predict — and avoid — rejections. Specific groups have reported an increase in rejections as payers investigated claims made in the early phases of the epidemic. However, this is due to continually changing payer limits. Aside from that, registration staff members continue to collect information from patients who are new to the healthcare system and are only looking for a COVID-19 vaccination or who are hospitalized because of COVID-19. With each new patient added to the system, the likelihood of data mistakes and omissions grows. It is impossible to overestimate the value of automation and predictive denial avoidance.

Automation can be effective for all types of practices

Organizations with high net patient revenue are statistically considerably more likely than those with low net patient revenue to have automated revenue cycle operations. Revenue cycle automation is employed by 83% of companies with annual net sales of more than $10 billion. Only 36% of enterprises with annual net profit revenue of less than $500 million employ it. These findings imply that smaller hospitals may be able to benefit from automation in order to improve revenue integrity and cash flow.

Additional recommendations for more minor medical centers and practices to consider are as follows:

  • Determine how automation can assist your company. Determine which procedures, regardless of the number of people engaged, may be made more efficient through automation. Is it feasible that a standardized, consistent approach to a task might be beneficial? Is it time demanding, and does it offer a good return on investment?
  • In many circumstances, it is easier to begin with automating fundamental procedures and subsequently progress to larger, more complex jobs. Insist on a roadmap outlining how your solution provider expects to ramp up efforts across the sales cycle.
  • Is there a problem with consistency, productivity, or accuracy among your Rev cycle employees? They may feel stressed because they’re being tugged in too many ways.
  • Smaller systems frequently believe they are too small to centralize, even when they believe it would be desirable. Automation can help you consolidate information by integrating your procedures.
  • When the current cost of automation is not fully appreciated because it is spread among departments or team members, getting buy-in for the effort may be difficult in smaller organizations. Collect all necessary data to show the amount of time spent on work across departments or employees. Then identify a problem area that must be addressed. Make a plan for redirecting workers to this problem area and how this will result in higher revenue.
  • Working with your team after you’ve implemented automation will allow you to reallocate time and resources to more important duties. Allow automation to handle the multiplicity of data procedures that would otherwise consume important human resources.