Revenue Cycle Management Services | RCM Automation

Problems	Solutions
Billing-related costs went from 2% to 5% for conventional Medicare and Medicaid to a surprising 17% for commercial payers.	Implementing RPA will reduce 60% of billing costs and have manual staff work on more important tasks where human intervention is needed.
According to industry standard numbers by HFMA and MGMA a sizable healthcare facility with 189,000 unentered and failed to capture charges claims in one month can lose 50% in revenue.	Robotic process automation for RCM tasks for healthcare organizations with such colossal volume will reduce 50% revenue loss and helps speed up claim reimbursement days.
A hospital with a normal of 75 weekly inpatient encounters would require 325 hours of work, also the effects on RCM KPIs, for example, DNFB and AR days.	Robotic process automation technology will save time and decrease costs by cutting short the manual workforce hours to 10 hours, and errors simultaneously.
Other dangers such as raising denials rates of which 15% is due to missing or invalid data from EDI and payer side.	Manual workforce human errors are significantly reduced and increased quality and productivity by 100%

Why is RPA the best choice of Hospitals and Health Systems?

Reducing cost:

Significantly reduces 60% of RCM operational costs. Reduces costs of hiring more resources.

Improves Quality and productivity:

Increased repetitive task productivity compared to the manual workforce. Industry-standard quality when compared to HFMA or MGMA data.

Continuous operations sustenance:

Bots do not fall sick or take days off allowing 365 days of operations. Lesser attrition rates due to staff burnouts.

Upgrading over time and compliance:

New payer guidelines are constantly updated and staff tends to catch up later. Bots comply with HIPAA and other Federal laws as they are programmed with these protocols.

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.
RCM Automation technology that works well with outpatient RCM services, automatically carries forward actionable steps in the outpatient RCM processes.

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.

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.

Frequently Asked Questions

1.What is Robotic process automation?

RPA is the utilization of AI programming to deal with high-volume, repeatable tasks that are expected manual workforce to perform. This robotic process automation can incorporate inquiries, estimations, and support of records and transactions. Further, robotic process automation (RPA)is the utilization of manual staff configurable programming and technology as a "robot" or "bot," to perceive patterns in the performance of tasks performed by manual workforce staff.
2.Is RPA expensive?

It depends upon your current workflow and the number of manual workforces used to perform these tasks. To decide the expense of RPA for your healthcare organization, it's critical to distinguish which tasks would benefit most from RPA bots. The critical point is to identify repetitive, concentrated areas of your workflow inside your work processes that require similar repetition without conscious human intervention. Those areas cost twice the amount when using a manual workforce instead of implementing RPA. Repetitive tasks are the best way to utilize RPA in cost reduction and return on investment.
3.Can robotic process automation be implemented in all RCM operations?

Yes, almost all parts of RCM operations can be automated and it depends upon the complexity of the tasks performed by these RPA bots. The best processes for implementing robotic process automation are repetitive repetitive high-volume tasks that are based on simple rules. There are tasks like migrating medical records that need much more customization in terms of regulatory compliance. These tasks are complicated but can be done when carefully programmed.
4.Which revenue cycle process would most benefit from robotic process automation?

RCM processes that have huge volumes of Manual tasks and intercommunicable processes all function well when implemented RPA. Manual entry processes, verifications, scheduling and registration, prior authorizations, etc are some of the RCM processes which need automation as they are tedious and time-consuming.
5.Does RPA avoid missing data denials in RCM processes?

Obtaining patient information is crucial to generating revenue for any healthcare organization. It is proven that more denials are in relation to the missing or incorrect patient data such as name, DOB, insurance information, etc. Dangers such as raising denials rates of which 15% is due to missing or invalid data from EDI and payer side. Manual workforce human errors are significantly reduced and increased quality and productivity by 100%.

Testimonial

What Our Clients say

Billing Paradise has done a phenomenal job on Our Project, We were very sceptical about changing our EMR from Office ally to ECW when we started doing our billing with BillingParadise, but the process was handled carefully without any difficulties for our patients & has Increased our collections. Over all our LAIMA Team is well pleased these past 2 years of doing business with Billing Paradise and you will be too!!."

Teresa A OBGYN Office Manager

Our Billing Paradise team feels more like our business partners than just another "outsourced" service. They personally relate any important information quickly and follow up in detail on all aspects of our billing, AR, and credentialing. Implementation of eClinical Works for our new business was flawless. They have expertly dealt with traditionally difficult and specialized US Dept of Labor billing alongside commercial insurance billing. We have had a very positive experience from the very beginning and look forward to many great years to come with them!"

Dr. Alina Sholar, MD Certified Plastic Surgeon in Austin TX

A lot of changes were taking place in our office, so we hired Paradise Billing to do our billing. They have been very efficient in handling our claims. They handled old claims for our office and have been very helpful in getting our old claims paid. Any time we have an issue or denials, Paradise Billing has responded in a timely manner. Our AR's are down and our collections are great. We have team that we work with and have access to them whenever needed. As the billing manager, I am very pleased with Billing Paradise. They have certainly made my job easier. I would certainly recommend them."

Susan S Billing Manager

Creating Better RCM Service Automation By RPA

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HERE IS HOW YOU CAN UNDERSTAND

The Benefits of automating your complete RCM processes.

End to End RCM processes which can be automated

Patient appointment scheduling and registration

Patient eligibility and benefits verification

Coding

Coding and coding errors resolution

Charge capture/entry

Payment posting

Denial management and appeals

Patient statements and collections

Hospital CFOs and CTOs determine that RPA is a product that can be bought and used like any other softwares/EHR in the market. RPA in RCM and medical billing process is supposed to be customizable according to the hospital or clinical group's specific requirement or the pre-set workflow.

We have 150 certified RPA resources experienced in the platforms below

Why is RPA the best choice of Hospitals and Health Systems?

Reducing cost:

Improves Quality and productivity:

Continuous operations sustenance:

Upgrading over time and compliance:

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

Fasten your eligibility and benefits verification process with RPA bots

Delivering EOB/EOP Electronification with RPA payment posting.

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

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

EHRs we work with

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

Testimonial

What Our Clients say

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