Work Smarter, Not Harder
Robotic Process Automation (RPA) - Part 1
Can a hospital with only a 50% clean claim rate decrease their eligibility denials
by 50% and increase point-of-service collections by 600%?
The answer is a resounding “Yes!” Magnolia Regional Health Center (MRHC), a
200-bed hospital in Corinth, Mississippi did just that.
According to Deonne Henry, Vice President of Revenue Cycle, the community
hospital improved patient access by automating each revenue cycle component from patient registration and insurance verification to cost estimates and patient collections.
Prior to employing RPA to automate patient access, MRHC staff relied on manual data entry and processes, including manually running eligibility. “You would have to get out of the registration questionnaire, go to a website, and
type in all the information that you just put into the questionnaire”.
The manual and duplicative process resulted in incorrect and incomplete
information on the front-end that translated into claim issues on the back end.
“Without RPA tools and…technology, none of what we've been able to
accomplish would have been possible.”
So, exactly what is RPA?
RPA uses specialized computer programs or “software robots”, “bots” for short, to automate and standardize repeatable business processes throughout multiple systems. It performs repetitive manual processes, freeing up time for high-value activities increasing timely payments from both payers and patients to provide a premium patient experience.
RPA exists in a wide range of applications from simply generating an automatic
email response to deploying thousands of bots, programmed to automate jobs in a system.
It is typically used to process transactions, manipulate data, trigger responses, and communicate with other systems. Roughly 36% of health care tasks can be automated as digital technologies and used by providers to create a more consumer-oriented healthcare model.
To remain competitive, hospitals will eventually need to provide patients with
digital solutions. By the end of 2019, it was estimated that 66%of U.S. health
systems were offering virtual self-scheduling and 64% of patients would book
Common RPA Uses in Healthcare
1. Scheduling Issues
"Anytown USA Community General Hospital (CGH)" was experiencing a
scheduling bottleneck because appointment volume exceeded Patient Access'
capacity to handle all incoming calls and arrivals. Appointments must accurately match available doctors and patients. However, staff had been registering patients manually which resulted in errors and oversights.
Bots were installed that offered appointment schedules to a patient according to their needs and doctor availability.
Once the appointment was booked, the bots scheduled it in the database & removed that appointment slot.
Bots then notified patients via email to confirm appointment details.
Accurate data collection, decreased Patient Access registration time,
and increased patient satisfaction.
2. Discharge Instructions
Upon discharge, patients are expected to follow the post-hospitalization recommendations to avoid costly re-admissions, but compliance was problematic.
Solution: (in addition to nursing staff speaking directly with the patient)
Bots were implemented to initiate post-discharge communication with the patient regarding exact discharge and post-treatment guidelines.
Bots sent timely notifications via text message or email to inform the patient of the schedule, appointments, and tests.
Bots also assisted the continuous communication required between doctor and patient post-hospitalization.
Outcome: Post-treatment compliance
3. Streamlining Audit Procedures & Regulatory Compliance
As with any hospital, CGH is faced with periodic clinical and financial audits and
surveys. Accurately assembling and organizing the data needed was labor-intensive, taking time away from other vital tasks.
Solution: Employ bots to perform data recording and report generation to
minimize demands on time and human resources.
Outcome: Timely well-organized internal and external compliance.
In Part 2 we will discuss the Benefits and Cautions associated with
using RPA bots to automate RCM.
We welcome your comments and questions
contact Donald Tapella at Medical Recovery Services
Phone: (816) 229-4887, ext.112
Fax: (816) 229-4787