You’ve undoubtedly heard the buzz around automation in the healthcare industry. But the buzz is perhaps loudest when addressing needs within revenue cycle management (RCM). Technology, billing and RCM organizations are working every day to improve the time-consuming and often frustrating tasks required for insurance reimbursement.
Why all this focus on revenue cycle automation? Because the benefits it can provide are monumental for both practices and health technology companies. Let’s dive deeper into these benefits and why they matter.
Understanding Revenue Cycle Automation
Revenue cycle automation removes some or all of the human element to revenue cycle work. It uses artificial intelligence (AI) or robotic process automation (RPA) to complete tasks and workflows.
RCM automation can take on tasks like:
- Prior authorization
- Insurance eligibility
- Patient estimates
- Claim processing and scrubbing
- Patient estimates
Reducing Workload with Revenue Cycle Automation
When it comes to workload and time spent with insurance companies, automated RCM workflows can benefit time- and resource-strapped providers. It can also alleviate workload strain for companies that manage the revenue cycle on behalf of providers.
Benefits for Providers
If you own or manage a private medical practice, you’re probably spread thin across various administrative tasks. And if you’re also a clinician who sees patients, you’re managing a clinic schedule on top of your practice operations.
Many practice owners we speak with estimate they spend at least five hours a week managing their billing and RCM. But when you can employ software that automates RCM and billing tasks, those five hours could go back to patient care and growing your business.
For example, the time spent handling denials and rejections could be used to work on a marketing campaign for the practice. The hours spent on the phone with insurers could translate to hours with patients on your waiting list.
Benefits for Health Tech and EHR Companies
If you’re an organization that handles some or all of providers’ billing, automating your processes within your software will save your team time. Reducing that manual workload — whether it’s calling insurers or scrubbing claims — means the team can focus on other areas of your product or platform.
Easing Burnout with Revenue Cycle Automation
Burnout is a massive problem in our industry today, both for clinicians and billing teams. Ultimately, this burnout has led to an exodus of healthcare professionals, leaving health organizations with employee gaps and communities with fewer physicians.
The primary driver of this burnout is administrative work. In particular, the U.S. surgeon general has called out prior authorization as fuel to the burnout fire.
With revenue cycle automation, teams across the healthcare industry can reduce the manual, repetitive tasks that often cause employee and clinician burnout. For example, AI can process and analyze data required for prior authorization. After examining patient demographic information, clinical notes and plan details, the AI can make a prior authorization decision for a payer or inform a decision-maker on what to do.
RCM automation can also reduce the time spent editing or scrubbing claims — another time-consuming step in the revenue cycle. Whether the platform uses AI or human-crafted scripting, the automation can lean on specific edit rules to avoid claim rejections and denials.
Growing Revenue with Revenue Cycle Automation
Perhaps the largest benefit of automated revenue cycle management is its potential to increase revenue.
Whether you’re a private practice, billing/RCM company or hospital, fewer claim denials and rejections means better reimbursement. Not only will you see higher revenue from more claims getting paid in full, you’ll also see the payment come in faster — fewer denials and rejections means less of your money sits in accounts receivable (A/R).
Reap the Benefits of Healthcare Revenue Cycle Automation
Automated revenue cycle technology can transform resource management and increase revenue for all types of healthcare businesses. Private practices can do more with less and strengthen their bottom line with more reliable revenue. And health technology organizations like EHRs or digital health companies can scale their business while providing a better customer-facing product.
Regardless of the type of healthcare business you manage, RCM automation can help provide a more solid ground for your business’s future.
Ready to optimize your operations with revenue cycle automation? Gentem’s proprietary RCM tech reduces time on billing and improves the insurance reimbursement process. Learn how it can help you grow your revenue and business by booking an intro call today.