Denial Automation

Signup For 15 Days Trial Program

HERE IS HOW YOU CAN UNDERSTAND

The Benefits of automating your complete RCM processes.

Increase in Productivity.
Increase in Accuracy/Quality.
Operations cost savings.

 

Decrease in Claim Denial Rates.
Decrease in Regulatory Compliance Issues

Upgrade your denial and appeal management team to tackle your claim denial challenges.


  • Denial and Appeal RPA provides process and workflow improved denial management protocols in identifying the root cause of denials and appealing underpaid and denied claims.
  • RPA bots analyze ERAs and apply rules to detect suspected payments and denials in the appropriate team or automated work queues.
  • Reduces manual consolidation of your denial reports when it comes to detecting aging, priorities with dollar values and payers.
  • RPA bots build KPI using data added by HFMA MAP Key provides quantitative management where data is measured and used to drive improvement decisions.
  • RPA bots protocols can be defined to guide each step in the denial/appeals process, eliminate missed appeal deadlines, generate email notifications, and facilitate communication across the hospital or medical group.
  • Cost reduction compared with hiring multiple denial management staff for creating paper work and generating reports for consolidation.
  • Major payers return up to 29 percent of claim lines with $0 for payment being estimated to cost providers as much as $118 per claim and that assumes the rework is done.



automation bots


We have 150 certified RPA resources experienced in the platforms below

White paper for RCM Best Practices
Anesthesiology practice case study
Orthopedic case study
Denial management whitepaper

We understand your concern for security and compliance

The RPA clinical data management in your system is 100%HIPAA compliant and is integrated into our RPA systems protocols to ensure your virtual work force remains as secure and compliant as your human one.

Get a 99.9% uptime guarantee, SOC 2 Type 2, ISO 9001, ISO/IEC 27001, and Veracode Verified

Major payers return up to 29 percent of claim lines with $0 for payment being estimated to cost providers as much as $118 per claim and that assumes the rework is done.

Categorizing claim denials:

Up to date database on denial guidelines: ERA denial CARC and RARC codes. Definitions of state and federal payer denial reasons.

Determining probability:

Usage of predictive analysis: RPA bots use 837 and 835 data to analyze denial trends across payers. DMA (Denial Management Analytics) rules in the bots for smart predictions.



Deadlines and TFLs:

Catching up with payer deadlines: Inbuilt rules set for the bots to analyze the TFL and appeal limit. Automatically detects the payer type for TFL ( commercial, federal and TPA liability).

Automated appeals:

Denial RPA contains around 150 top insurance payer appeal forms. Bots automatically captures claim, denial and patient information in the appeal form.

End to End RCM processes which can be automated

  • Patient appointment scheduling and registration.
  • Patient eligibility and benefits verification.
  • Charge capture/entry.
  • Payment posting
  • Coding and coding errors resolution.
  • Accounts Receivables.
  • Denials and claim appeals.
  • Patient statements and collections.

Easy, less hassle and proven RPA solutions for higher patient volume health systems, surgical groups and clinics.

  • Less manual workforce required to register new patients and schedule existing patients appointment data.
  • Allows data to be forwarded to the front office records and doctors device to have better patient engagement.
  • Bots can navigate across multiple facilities and respective scheduling applications they use.
  • RPA bots can act as a patient support and guide them through the registration or scheduling process.
  • Increases productivity by 100%
  • Significantly reduces cost and increased patient volume simultaneously.

Fasten your eligibility and benefits verification process with RPA bots

  • Connected with more than 1500 payers across the country.
  • Bots are able to perform a wide range of searches if the patient information is limited.
  • Creating batch audits for hospitals and health systems with 100s of patient volume a day.
  • Faster eligibility checks within 5 seconds of request.
  • Includes TPAs, IPAs and other liability eligibility verification.
  • Cost friendly and lesser staff utilization for this process by utilizing RPA

Delivering EOB/EOP Electronification with RPA payment posting.

  • State of the art optical recognition technology
  • Best of breed multiple OCR engines
  • State of the art Machine learning
  • Semi-structured form classification
  • AWS services (SQS, S3, etc...)
  • Elastic search (history-based validations)

Leveraging advanced RPA coding technology to produce the most efficient and accurate solution for identifying, documenting, and coding.

  • Supports both ACA Commercial and Medicare Advantage lines services and procedures.
  • Includes both CMS-HCC for Part C and RxHCC for Part D.
  • Configurable 2-stage ICD Parser that looks for all types of medical condition presences ranging from abbreviations to combination.
  • Latest updates from CMS included in the bots RAF databases , including complete ICD-9 and ICD-10 code list.
  • OCR that identifies content from medical records and charts, converting it into XML schemas and enabling which produces results in low TAT.
  • Cost reduction compared with hiring multiple AAPC certified coders.

Implement RPA technology which is reliable and self learning.

Works With all EHRs open for custom integration.
Customizable according to your health system, hospital or clinical group
Faster development and deployment with interoperability.
Ownership of the RPA and quick ROI.

Denial and appeal RPA is a data agnostic bot. It has the ability of one system to work with many systems, rather than being designed for a single system. A system that is “data agnostic” can work with information received from heterogeneous databases, i.e. databases with dissimilar data formats.

EHRs we work with

At BillingParadise we know the features and workarounds of your EHR system. All our RCM tools are integrated with the system you use.

Frequently Asked Questions

  • 1.What is Robotic process automation?

  • 2.Is RPA expensive?

  • 3.Can robotic process automation be implemented in all RCM operations?

  • 4.Which revenue cycle process would most benefit from robotic process automation?

  • 5.Does RPA avoid missing data denials in RCM processes?


Why Billing Paradise

80+

Organizations

25+

EHR Software

1

Million claims

20%

Growth Per month

You can bank on us because we are certified by...


We understand that implementation of RPA might be different from each and every practice and their EHR to get comfortable with the RPA we are providing our client half a month trial program where clients can operate these RPA bots and get the workflow setup they need. This allows you to identify the key tasks in which RPA can function and the rest 10-20% can be done by a manual workforce

Act now to obtain this offer.
Talk to our RPA experts to learn more.