RPA implementation guide for healthcare RCM

 Erika Regulsky RCM, RPA
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Introduction to RPA implementation guide for healthcare RCM

Healthcare decision-making leaders like CEOs, CTOs, CFOs, and RCM directors are likely to have an idea about what robotic process automation is, the main concern they are worried about are questions they have about the successful implementation of RPA in revenue cycle management. There are certain challenges every hospital or health system faces during the implementation of RPA, these challenges can be addressed before implementation for successful utilization of RPA bots.

Why implement RPA?


Robotic process automation is transforming the way healthcare organizations perform their revenue cycle management (RCM) to automate simple repetitive tasks, tasks that need higher accuracy rates by referring to multiple sources, guidelines, and regulation documents while improving production, quality, and the end result saving cost. Here are four main implementation reasons why RPA can be successful for your organization:

Increased efficiency and productivityRPA bots do not take breaks or vacations. It performs x5 times faster than your human staff FTE

Reduced human errorsRPA bots significantly reduce human errors. Reduced errors mean reduced re-work tasks and time-saving. 

Scalability and FlexibilityRPA workforce are scalable from large to small depending upon operational needs. RPA bots can be programmed and added to your operations any time of the year as they need not go through human resources hiring formalities. 

Cost reduction –  Increased overall cost saving total cost savings by 50-75%. RPA bots only cost 20% of human staff (full-time employee) expenses. 

Questions that guide you to an appropriate RPA implementation in RCM

There is no concept of a one-size-fits-all methodology for RPA. Every hospital and health system ought to think about their unique requirements, existing applications, data, workflows, and RCM processes and embrace change. As you think about RPA Implementation, pose these questions to recognize potential open doors that are ideal for incorporating robotic process automation technology:

  • Could the RPA process at any point be broken into a set of if/then decisions and RCM operating rules?
  • Does the cycle require human mediation, as decisive reasoning, to finish?
  • Is the information present accurate and available to RPA bots?
  • How much manual workforce time is expected in the ongoing RCM process that could be dispensed with or redeployed through RPA?
  • What is the effect from the patients’ point of view? Might it at any point increase or decline patient service fulfillment?
  • Could the  RPA process at any point incorporate an inherent monitoring framework to assist with relieving risk in the event that a process fails or is delayed? What is the risk factor to the entire hospital or health system if the step fails? 
  • In the event that RPA is a convenient choice, does it give a total solution for automation or are complementary applications expected as a component of the robotic process automation?
  • How could the RPA bots be scaled and implemented across the entire hospital or health system to achieve greater value? 

Guiding points for RPA implementation in RCM

It is a well-known fact that RPA performs well, reduces costs, and increases productivity and quality. But, there are certain areas you would like to identify for a better implementation of robotic process automation in RCM. Here are the important guiding points essential for the implementation of RPA in RCM:

Understanding the current workflow of RCM

Implementation of RPA needs a thorough analysis of your current RCM processes and workflows in order to. Identify the problem areas where implementation of RPA will be more effective. 

Strategies for feasibility

Usage of both RPA and RCM subject matter experts. They will provide valuable insights in regards to the technical and practical aspects of implementing RPA in RCM. This allows you to identify the feasible and most cost-effective way where you can achieve ROI worth utilizing the RPA technology. 

Adjustment of RCM processes

The next part is adjusting your current RCM processes. Your organization may have staff working on processes that need no additional resources after the implementation of RPA. Adjusting your resources according to the changed RCM processes enables effective human and robot resource utilization. 

Obtaining clientele use cases

RPA programmers will have use cases from their previous clients which are true success stories that you can rely upon when choosing the right RPA vendor. This information is very valuable for determining the capabilities of your RPA technology providers. 

RPA implementation challenges for healthcare organizations in RCM

Healthcare organizations like hospitals and health systems with median working margins of 1.6% should really oversee both income and expenditure factors. 

The two greatest expenses for hospitals and health systems are RCM and human resources, estimated roughly at 60% of the entire operating expenditure. 

Indeed, even with the top of the line healthcare RCM tools and EMRs, most hospitals and health systems still deploy human staff to work across low-value impact tasks and processes (tedious, repetitive, labor-intensive tasks like manual entry processes)

The major issue is that it prompts higher staffing costs, fewer efficiencies, decreased productivity and reduced resource capability. 

Solutions to elevate manual labor challenges using RPA

In order to triumph over the stress to improve, healthcare organizations should change their RCM workflow by incorporating an automated workforce and embracing RPA.

More hospitals and healthcare organizations are deciding to implement robotic process automation and realized the efficiency of using a digitized workforce, utilizing RPA answers for change in front, center, and back-office operations, empowering their human workforce to concentrate on more value-added and crucial tasks which only a human can perform. While the essential and quick benefit of utilizing RPA is cost reduction,  it also has a few different advantages that include but is not restricted to:

  • 24/7 365 days round the clock operations
  • Higher accuracy rates
  • Increased quality
  • Less human intervention
  • Quicker work delivery and turnaround time
  • Scalability
  • Flexibility
  • Reduced compliance risks
  • Allos human workforce to concentrate on much more complex tasks.


Understanding your RCM process,  revenue, current platforms (EHRs) usage, and a number of human staff all play an important role in implementing RPA in revenue cycle management. These are the factors that determine the useful implementation of RPA. Unlike other technology, RPA is tailored to suit your hospital or health system’s current RCM operations, so reasoning questions and a thorough analysis of your RCM processes are a must and also a great guide to starting setting up RPA for the best. 

Learn more and raise much more complex questions to our RPA experts! We are ready for the challenge! 

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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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