How Intelligent Automation can Help you Serve More Patients

As a healthcare practitioner, it’s important that you are paid on time for the services rendered. While it may seem like a simple ask, it’s unfortunately not so straightforward. 

Revenue Cycle Management is a labyrinth of strict requirements, rigid timelines, and complex regulations. Then when you add in operational inefficiencies, labor shortages, and an ever-evolving billing environment – cash flow quickly becomes unpredictable for intelligent automation for patients.

Three Contributors to Disruption 

1. Rising denials 
   From a denial rate of 9% in 2016 to 11.1% at the end of 2020, denials have continued to increase over the past five years.
2. Bad debt from high patient accounts receivables 
   Providers across the country are concerned that high insurance deductibles are making it harder for patients to pay their bills. This results in accounts being written off, generating bad debt. Even when you do get paid, there is generally a greater lag time between provision of care and collection of payment. 
3. Staffing challenges and poor retention 
   2022 has seen one of the tightest labor markets in quite sometime. According to Morning Consult, one in five health care workers have quit their jobs since February 2020, and of those who have stayed, 30% are currently considering leaving.
   Industry leaders are looking for every possible solution to these challenges from increasing staff to outsourcing and adding to tech stacks. However, the real answer lies in Intelligent Automation for patients.   

Providers across the country are concerned that high insurance deductibles are making it harder for patients to pay their bills. This results in accounts being written off, generating bad debt. Even when you do get paid, there is generally a greater lag time between provision of care and collection of payment. 

To bring about any meaningful change in the revenue cycle, go back to the beginning- the front desk. Front desk denials have been a top cause of denials since 2016.  

• 27% of denials result from registration and eligibility errors 
• 22% of denials can be traced back to pre-authorization issues. 
• 30% of claims submitted the first time are denied. 
• 60% of claims are never re-worked due to lack of time and/or knowledge 
• 90% of denials are preventable 
• $25 is the cost to appeal a single claim 

All of this happens mainly due to a lack of clinical experience to manage denials and support appeals, inadequate training, and substandard technology.  

Now you may ask why you should start troubleshooting at the front- desk. Well, there are three main reasons.  

1. Patient Satisfaction 
   The front desk office is the key driver as it is where first impressions are made upon patients. It only makes sense to automate and simplify the patient registration process. 
2. Data collection
   It’s imperative that this information is accurate as it forms the basis of further investigation.
3. Revenue cycle processes 
   These are usually based on manual workflows and can cause patients to feel frustrated when they are repeatedly asked for the same information. 

How are organizations currently addressing these problems in intelligent automation for patients? 

At present, some leaders are turning their attention to staffing solutions that include higher salaries, flexible schedules, and remote working opportunities. According to an MGMA survey, 56% of medical practice leaders reported that increasing wages helped them retain staff. However, substandard processes and cumbersome manual processes still need to be dealt with. 

Other leaders are investing in solutions such as eligibility tools, intelligent automation for patient portals and appointment confirmation services. But this leaves a lot to be desired as the services tend not to be integrated with the revenue cycle ecosystem and their features can overlap to create more downstream tasks for staff.  

A great solution is to outsource all or part of the intelligent automation revenue cycle management process to third-party vendors. While this is a wise move, many vendors also face a huge amount of manual burden which can ultimately affect the patient’s financial experience. 

Evaluating automation solutions 

To establish a proactive and patient-centric financial experience in which all stakeholders benefit, it is imperative that you are equipped with tools that can enable you to collect all of the necessary information to submit a clean claim. At the same time, it’s also important to get rid of repetitive, labor-intensive tasks. Fortunately, automation helps you to achieve all of this. 

So, what can intelligent automation for patients do for you and your patients? 

For you: 

1. Help alleviate your eligibility errors by eliminating manual tasks
2. Reduce bad debt for your practice
3. Overcome staffing challenges
4. Reduce operating costs while producing higher yields
5. Allow the front desk to provide a richer patient experience
6. Improve productivity of staff
7. Differentiate from competitors by providing a patient-centric experience

For your patient: 

1. Simplify their experience
2. Reduce friction points
3. Provide an advance and personalized check-in e
4. Reduce wait time
5. Engender transparency and protect from surprise costs through estimation tools during the intake process
6. Provide various billing options along with easy-to-understand cost information

How to select the right intelligent automation partner: 

Choosing to pursue Intelligent automation for patients as a front-end revenue cycle solution is often a favorable choice. However, there are various factors to consider when deciding who to partner with:

1. A partner that can address the unique needs of your practice.
2. A partner that can support automation in all areas from patient registration and check-in, to authorizations and claim status for follow-up or denials.
3. A partner that can scale as your practice changes or expands.
4. An automation intake agent that allows patients to complete a fully digital pre-visit registration and self-report clinical information.
5. A partner that provides tools that can manage prior authorization submissions along with analyzing the requirements and managing the approvals.
6. A partner committed to providing continuous feedback to improve outcomes.

Intelligent Automation for patients of RCM workflows has significant potential to boost revenue performance and help ensure that your practice depends on timely payments.  

Interested in learning more? Contact us.