Hospitals implemented RPA and saw 70% improved resource cost.

 Erika Regulsky RCM, RPA
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The reason why human workforce cost increased

The cost of maintaining the complete RCM process and the expenses that come along with updating your hospital every year in terms of human resources, EMR, and other in-house IT-related financial burdens. Nowadays hospitals rely on robotic process automation (RPA) and reduce the cost of running a fully functional hospital with a streamlined RCM department. RPA is now being implemented where human staff is lacking to achieve production numbers, quality, and compliance. It is not the fault of human staff to achieve more productivity or quality, it is just that human resources tend to burn out over time when performing repetitive and tedious tasks that robotic process automation bots are successful in performing. 

Post pandemic situation created inflation and an increase in cost related to the RCM workforce shortages. In a survey conducted last year (2021) the cost of qualified RCM experts increased by $24 billion a year surpassing pre-pandemic situations, which is an 8 percent hike per day compared to 2019 numbers. However, it is not the answer to eliminate all human workforce. The answer is implementing robotic process automation (RPA) where there is an overutilization of the human workforce by the end result of performing those tasks that are not up to the expectations as human error is a key factor in these areas of RCM. Furthermore, the human workforce tends to wear out over time from performing manual entry and verification processes in RCM.

Ways to implement RPA that will increase improved resource utilization and cost-saving

In order for your hospital to properly use the human workforce and implement RPA in such a way that both the human workforce and robotic process automation can co-exist in a harmonious manner and save cost simultaneously, you would need to understand the problem areas and how it can be resolved with RPA. There are multiple RCM processes that do not need a more human workforce which can be performed by RPA bots and few processes that purely need a human workforce. Let us break it down for you:

Front office tasks

Front office tasks are often tiresome when a front office staff(s) need to perform them. The core responsibility of any front office staff is to guide patients who are in the hospital looking for care. If the front office staff are more curious about scheduling appointments and gathering data over phone calls or the EHR system takes 30mins, this will only delay the patient as most front office staff place calls on hold to pay attention to more pressing matters with the patient during their visit creating a pressured work environment for your front office staff and resulting your RCM director informing your CFO for additional budget to hire an extra front office staff. Say your hospital pays $3-$6k a month for front office staff and you would have to hire an extra 2-3 depending upon patient volumes you will be spending $180k on an average per year for front office manual tasks alone. Robotic process automation (RPA) enabled front office tasks like patient scheduling, registration, documenting gathered data, or guiding patients through your website to make payment can be completely automated and these processes will be done automatically without front office staff intervention. Implementation cost for this particular RPA will cost an average of 15-20% depending upon the complexity of your front office processes. This cost is one-time and the cost of maintenance of the RPA bots will be lesser over time as the RPA bots are adaptive.

Repetitive processes

Repetitive processes

Most RCM processes are repetitive, especially for patients with recurring visits or with chronic conditions. These repetitive processes include patient eligibility and benefits verification, demographic entry, charge capture, prior authorization, etc. The human workforce in these processes may range from 10-15 resources depending upon the patient’s volume. If your hospital is going to pay $350k per year for these resources and are getting more human errors as well, then utilizing human resources for those repetitive manual entry and verification process ROI is significantly lower as the denied claims need to be worked on which cost even more extra. Robotic process automation (RPA) for these manual repetitive processes only costs half of the expenses anywhere between $50-$100k as a one-time expense and the monthly maintenance costs of these RPA bots are even less anywhere around $3-$5k per month.

Data management and compliance

We all know health information is protected and any breach of PHI is punishable by law according to HIPAA. Clinical data management such as medical records, patient demographics, etc is constantly at threat of being exposed by hackers and within the organization itself. Hospitals pay over $10 million dollars every month due to data breaches. Robotic process automation (RPA) assisted data management and compliance will not only perform the creation of medical records, patient encounters, and surgical reports on behalf of the physician, it also protects the data and monitors the users accessing it, and creates security measures and logs for future examination or audits saving your hospitals millions of dollars in fine and enabling you to get positive reputation, getting feedback from patients and healthcare authorities. 

Overall, when we calculate the human workforce utilization and implementation of RPA in certain RCM processes a hospital can find up to 70% improved resource utilization cost. Hospitals and health systems are supposed to oversee their core functions: patient care, managing clinical staff, affording treatment technologies, etc. If a hospital is going to spend more on the human workforce and does not get ROI for that, it is then certain that they need to switch to alternative options like robotic process automation (RPA). RPA technology not only increases productivity, accuracy, and cost savings but also allows you to direct your human workforce in more high-value functions like analyzing ways to improve RCM processes, reimbursement rates, patient treatment plans and most of all serve without burning out. Healthcare CFOs, RCM directors, and other management-level executives who are looking for a positive impact on their hospital’s revenue and would like to cut costs at the same time are welcome to learn more about our RPA services. BillingParadise expertise in manual RCM processes combined with RPA technology programming can create RPA bots suited exactly for our client-specific needs. We are offering demos and discount opportunities to clients with complex end-to-end RCM automation needs. Schedule a conversation with our RPA experts now!

 Appointment Scheduling using Robotic Process Automation

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I’m a multi-certified revenue cycle management professional and compliance officer with 20+ years of experience. I contribute articles to leading healthcare publications and journals. I am currently working as Senior Transition Manager, in BillingParadise headquartered at Diamond Bar, California. BillingParadise offers Medical Billing Services that intersect perfectly with the EMR/Practice management system you use.BillingParadise has offices in New Jersey, New York, Florida, Georgia, Minnesota, and Texas.

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