RPA use case for charge capture and entry

 Erika Regulsky RCM, RPA
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Capturing patient diagnosis, procedure, and demographic data during every visit is a crucial step for any healthcare organization to make revenue. If this process doesn’t contain consistent quality and verified data then the step to earn revenue for that hospital will be minimal and poor financial performance is underway. Robotic process automation (RPA) charge capture and entry technology will ensure the charge capture and entry data are precise with no margin for error. 

Hospitals and health systems are aware of RPA technology implications as a whole, but there are significant use cases for RPA-enabled charge capture and entry. We have consulted with our RCM and RPA experts to derive these use cases which are helpful for management and decision-making leaders such as CEOs, CFOs, CTOs, and RCM directors. Let’s explore the RPA use cases for charge capture and entry. 

RPA use case for charge capture and entry process

Time and cost-saving

Time and cost-saving

The first and foremost use case is reducing cost and time with RPA for the charge capture and entry process. It is a well-known fact the charge capture process is done by physicians, NPs, Or PAs during the visit. Then they use the manual entry staff to enter the captured data in the EHR software. However, hospitals and health systems with huge patient volumes fall back on entering these charges and the hospital management has to hire more manual entry staff for instance if a hospital has 60 inpatient visits a week and they are monitored by PAs NPs, etc that charges are also to. Be included on a day-to-day basis which means they utilize 150+ manual work hours to complete it and the salary for the entry staff FTE would be approximately $100K per month. On the other hand, using RPA for the charge capture and entry process will reduce the time for those 60 patients by 1 or 2 hours at the least. The return of investment for RPA bots to perform charge capture and entry would be a lot quicker compared to manual workforce staff.

Unattended fully automated RPA bots

Hospitals and health systems usually have manual processes like utilizing superbills and writing down the diagnosis,  prognosis, treatment plans, etc. This actually creates confusion and the manual entry staff for the captured charges data may be incorrect and the entry staff cannot bother physicians as they will be busy treating patients and even if their schedule frees up it takes almost a week’s time for the clarifications to be done and bill the claim successfully.

Robotic process automation (RPA)  for charge capture and entry is very versatile and adapts to your hospital’s current charge capture and entry workflow. It ensures that the captured charges are in an electronic device, so physicians using a tablet or any mobile device to capture charges can benefit more from RPA as the bots will automatically guide the doctor, NP, or PA in the correct diagnosis, procedure, and treatment plan as they are inbuilt ICD 10, claim edits, CMS coverage determination access will prevent these healthcare providers to capture charges easily without errors. Secondly, during charge entry, there is no need for manual charge entry because the unattended bot will automatically carry forward the entry of charges in the EHR as soon as the data has been received from the charge capture side of the workflow. This uncomplicates the whole process and accountability of all charges are logged to compare reimbursement rates, underpayments, denials, etc. for future audits and reporting purposes.

Multiple applications accessibility

Manual charge capture and entry processes needs support of multiple applications. Most EHR applications do not have the facility of using mobile charge capture plugins. They need to be manually logged in to capture the charges. Likewise for manual charge entry processes the entry staff need to access multiple applications to enter one encounters charges properly. RPA-enabled charge capture and entry system surpasses the manual charge entry and capture processes by using multiple applications at one go which includes EHR, payer portals, clearing houses etc. Typically an unattended bot with this multiple applications accessible feature will no longer need manual entry staff to assist, but just to monitor the process and checklist of workflow programmed under the RPA bot. This is the most impeccable RPA use case for charge entry as using multiple applications at a time might be tedious and possibilities for errors are low. 

Compliance and data security

Patient data and other PHI is 100% involved in the charge capture and entry process. Hospitals and health systems pay over 1 billion each year as a result of serious HIPAA compliance and PHI breaches. When implemented, RPA-enabled charge capture and entry technology is capable of securing data more effectively than entry staff and detailed logs and permission to access records can be controlled by the RPA bots ensuring 100% compliance and security. Hospitals and health systems facing regular audits related to these issues must consider implementing RPA and obtain the benefits of a safe and data secure workflow. 

RPA-enabled charge capture and entry technology is being used by many of our clients with high patient volumes, they have benefited in cost and time saving, productivity, quality and efficiency. They are also surprised by the unattended bot which performs these tasks 24/7 every day for 365 days making sure the obtained data are verified and entered without errors. If your healthcare organization is facing higher than usual staff attrition rates, it is better to adapt to RPA sooner. BillingParadise and its RPA team combined with in-house RCM experts have devised this technology that is dedicated to hospitals, health systems and clinical groups. If you are looking to implement RPA and have questions our RPA experts are here to help just a click away, schedule a call and discover more about RPA now! 

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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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