Optimize performance while reducing costs. That’s the financial objective of every provider organization but throwing more human capital at increasingly complex tasks is an expensive proposition. Enter intelligent automation. By transferring repetitive, high-volume tasks to software, intelligent automation helps free up revenue cycle teams to focus on more complex, human-touch-required processes.
What is intelligent automation?
Automation in the revenue cycle is hardly a new concept. For decades, organizations have relied on automation to streamline a complex system of concurrent and connected processes related to billing, coding and collecting, among other tasks. But rapid advancements over the past decade requires a more robust definition. Intelligent automation sits between robotic process automation (RPA) and artificial intelligence (AI), but increasingly closer to the latter, which is why it’s also sometimes known as AI automation.
No matter what you call it, when applied to the revenue cycle, these smart tools can help hospitals accelerate collections, resolve denials faster, increase productivity, enhance office efficiency, improve the quality of their data, and more.
How can intelligent automation be used in the revenue cycle?
Its versatility can be overwhelming—and deciding where to apply intelligent automation in your workflow can be an arduous task. A good starting place is this list of common applications:
- Back-end A/R follow up: This is not only a critical component of the revenue cycle, but it also has many manual, repetitive processes such as checking claim status on payer websites. HealthLeaders recently reported on a South Dakota health system that implemented intelligent automation to follow up on the approved/denied status of outstanding claims. As a result, the system saw $20.6 million in accelerated cash flow within 18 months of implementation and also saw a $1.1 million net impact in timely filing improvement. Additionally, the number of claims needing follow-up was cut in half, and the health system achieved $260,000 in FTE annual savings.
GAFFEY Healthcare offers an intelligent automation tool, AutoStatus, that automatically queries payer databases for claims status and interfaces with an organization’s patient’s accounting and billing system. Not only does AutoStatus eliminate the need for revenue cycle employees to manually check for claims status, it identifies denials and problem accounts earlier in the collection process—on average, 14 days or sooner than waiting for the 835 information—giving rev cycle staff a jumpstart on resolving denials.
- Claims prioritization: First in, first out? Or should revenue cycle teams tackle high-dollar claims first? Prioritizing a claim can take more time than processing the claim itself. Intelligent automation can transform this tedious process from a guessing game into a rule-based system that ensures collectors are focusing on high-dollar account balances and aged claims first.
- Streamline workflows: Revenue cycle often takes second place to a hospital’s clinical information needs. That reality often results in disjointed applications and a combination of system-patches and various manual workarounds, which are not only time-consuming but also introduce the opportunity for multiple errors. By applying intelligent automation to workflows, organizations can minimize the steps to collect and streamline key processes, allowing staff to work more A/R each month while increasing their efficiency with each touch.
GAFFEY Healthcare’s AlphaCollector can help revenue cycle departments overcome both the challenge of inefficient workflows and claims prioritization. While other systems require collectors to view up to 13 screens per claim, AlphaCollector can perform the same function in just three steps. Using the information from the payer websites, as well as the denial reason codes from electronic remittances, the tool also recommends actionable follow-up activities to ensure quick response to priorities and issues.
Will intelligent automation ever replace rev cycle teams?
There is no credibility to the myth that computers and robots will one day replace humans, especially when it comes to the hospital revenue cycle. There will always be a need for human touch in this increasingly complex industry, and tools like intelligent automation and artificial intelligence will change the way revenue cycle teams work. There will be a lot less focus on high-repetition, error-prone tasks, leaving staff to focus on more complex tasks. That means working claims that fall outside of rule sets, providing stellar, empathetic customer service—and rev cycle staff seeing themselves less as bill collectors and more as patient advocates.