Business Process Automation For HealthCare Providers

Medical credential service providers verify that healthcare workers possess all the requirements and credentials to provide services to patients. This process entails lots of back and forth and manually entering data into a variety of forms to provide proof of information like education, training, licensures to satisfy compliances. Process automation can be implementing to speed up the credentialing process and remove human error.

Though appointment booking has mostly moved online, knowledge workers still have responsibilities in this workflow. But not with RPA. When a patient requests an appointment, a software bot verifies patient records and insurance. For any incomplete data, the bot can request it and also create a new entry if there is no data available. Next, it will automatically send available time slots to patients, schedule appointments in the database, remove cancelled appointments, and notify patients of appointment details via email. Patient reminders can also be sent out by the software bot. This significantly speeds up the process and return coveted time to administrators for better customer service.

Ensuring efficiency and quality of safety during procedures is done through a long and tedious manual auditing process. Knowledge workers must determine if compliances were met during a patient care interaction or procedure. RPA can automatically identify and select the patient or procedures for audit to save time and improve compliances.

The process of accepting patients is time-consuming, which is why billing companies are starting to automate. Process automation can identify changes in a patient’s insurance, audit real-time eligibility data based on specific payer rules and historical denial patterns, alert billers on issues like wrong payer or benefit limitations, confirm service-level benefit coverage, detect found coverage, and more. The
data is then extracted, and input into a database. RPA for patient eligibility check reduces denial rates, saves employees time, and improves patient experience.

While the use of Electronic Health Records (EHRs) has significantly improved data handling processes, it is still exhausting for =employees. Automation can help mitigate data issues like duplicity and incompleteness in a time-efficient manner. It does this by scraping the data from EHRs, reading associated PDF/image document and making it all uniform via programmed business and data edit rules. Software bots can then quickly and easily move this data into other databases and systems or alert users on exceptions

Manually configuring healthcare contractors’ compensation is tedious for knowledge workers. Instead, RPA can be introduced into the workflow to automatically calculate a healthcare workers pay based relative value units (RVU), the time a healthcare worker was clocked in, and/or the procedures they participated in. Automating these pay structures will speed up the process and get healthcare providers paid quicker, resulting in higher levels of satisfaction.

The claim processing workflow requires speed and accuracy. However, most claims are entered into the claim system by hand. RPA bots can be programmed to automatically open and analyze claims data from emails, web forms, and/or PDFs. The correct data can be extracted and input into the claims system, while the incorrect data can be reconciled. At the end of the process, RPA can send a confirmation report with all the approved and denied claims.

The processes of manually collecting data from emails and FPT/network drives is agonizing for already-busy care providers. Then there’s the added step reviewing the data and entering it patient records on EHRs. RPA can eliminate challenges by automating this process and provide immediate and long-term benefits to patients and providers.