Medical Billing Automation
The medical billing process, performed by healthcare providers, is a multi-step process that involves the use of medical codes, claim processing with payers, and recovery of out-of-pocket expenses from the patient. It requires the collaboration of both internal and external stakeholders, with the manual collection of data from each stakeholder.
RPA can combine all of the sub-processes performed by each stakeholder into a seamless, centralized process. Medical billing service providers, with the help of RPA, automate the billing process for their healthcare provider customers, which will result in significant time savings
Medical Billing Automation Benefits:
- Claim filing: Typical claim processing is a time-consuming activity that involves repetitive tasks and gathering of vast amount of data information from different sources. With predetermined rules, RPA can extract structured and unstructured data, update systems and identify exceptions. The automated process reduces average transaction times from 12 to 2 minutes.
- Member enrollment: The need for healthcare insurance keeps growing every year. Payers have to process a huge influx of new member enrollment requests. It is a manual process that involves a tonne of paper work, the physical movement of paperwork, and tremendous attention to detail through human eyes. RPA can automate the entire process seamlessly, and bring down the processing errors and incomplete applications; subsequently reducing the turnaround of enrollment cycle times.
- Provider network management: Payers have to spend an equal amount of time and effort in managing the healthcare providers they collaborate with. Bad provider information could impact operational inefficiencies, like low auto-adjudication rates, wasted time and dollars in terms of tracking provider details, etc. These are typically caused due to errors or missing information, like phone numbers/incorrect address in provider records. RPA can reduce the cost of maintaining provider data and improve overall integrity.
- Contract management: It is not just about adding a new provider or renewing the contract of an existing provider; payers process large volumes of data in both structured and unstructured formats. Search/retrieval, relationship management, and reporting are some of the areas that face challenges due to highly time consuming and error prone manual processes. With OCR (Optical Character Recognition) enabled RPA and IPA (Intelligent Process Automation), process efficiencies can be achieved in these areas.