A Beginner's Guide to Robotic Process Automation for Medical Billing

Have you heard?  The newest buzz term that seems to be floating around every healthcare event this year is “Robotic Process Automation” or RPA for short.  It sounds intimidating, but there are many real-life applications of RPA that exist today that automate the manual tasks associated with medical billing.  Let’s take a deeper look into what RPA does, why it’s important to the world of medical billing, and how practices can take advantage of it without breaking the bank.

Gain efficiency in every step of the revenue cycle with ImagineSoftware's RCM solutions.

btnLearnMore orange


What is Robotic Process Automation?
Robotic Process Automation (RPA) is a software robot that automatically conducts routine tasks to standardize repeatable business processes.  These software bots mimic human activities by interacting with applications in the same way that an employee does. You can think of RPA as a virtual assistant, an invisible employee that completes tedious tasks that allows your real employees to concentrate on more important revenue-generating tasks.

What are the benefits of RPA? 
As a software solution that acts as a low-cost virtual employee, RPA provides an array of benefits that ignite interest from many industries including healthcare.

Reliability – Operations can be performed 24/7 as the bots work autonomously, only requiring human intervention when an employee must make a decision to guide the bot’s next move or to correct an error that the bot caught.

Compliance – RPA will follow company compliance rules and will often provide an audit trail history of the work performed.

Consistency and Accuracy – RPA is configured to perform specific tasks the same way every time with no deviation.  This allows for extreme accuracy and uniformity in task completion compared to simple human errors like typos.

Productivity – Process cycle times (in this case, revenue cycle processes) can be performed at a much faster speed compared to manual work, since the bot operates according to an automated schedule.

Why is Medical Billing relevant to RPA?
Believe it or not, Robotic Process Automation can be added to almost any step of the medical billing process to help automate and standardize areas that are mundane and time-consuming.  Here are some of the most common areas:

Payment Posting

Automated payment posting can help improve productivity and streamline the manual processes of posting insurance payments.  Payment posting is an integral part of revenue cycle management, and if done properly and accurately, will improve cash flow and patient satisfaction.

Electronic Remittance Advice (ERA) is an electronic version of a paper explanation of benefits (EOB) and includes details about the amount billed, the amount being paid by the health plan, and an explanation of any discrepancies between the two.  There are many advantages to adopting ERA, one of which is automated payment posting.  ERA is intended to work in unison with the rest of your medical billing technologies without human intervention.  This allows for faster account reconciliation, fewer operating costs, and enhanced staff productivity.

EHR Automation

Electronic Health Records (EHRs) were designed with the best intentions, to provide valuable patient information in digital form and to make the lives of physicians easier.  Unfortunately, 42% of doctors said they have experienced a burnout at some point in their careers and a major contributor is the adoption of EHRs.  Doctors are spending more time than ever before in front of a computer screen instead of spending their time interacting with patients.  RPA bots can fill in EHR fields automatically and duplicate necessary information across different systems.  This reduces human error and allows physicians to spend more time with their patients.

Claims Administration

Inputting, processing and adjusting claims takes up a considerable portion of administrators’ time.  Claims management is extremely prone to human error, which is typically the cause of initial claim denials.  RPA solutions like ImagineAppliance® automate many of the tasks associated with claims administration including charge coding, checking against payer rules and submission.  In addition, “The ImagineAppliance® gives us the granular ability to figure out what happens to a denial depending on its corresponding insurance plan,” said Robyn Allen, IT Trainer and Software Administrator at Central Kentucky Radiology.  “This is a huge improvement for us overall.”  According to a report by Ernst & Young, automation can reduce turnaround times for insurance claims by as much as 75-85% and eliminate 50-70% of repetitive tasks entirely.

As pressures rise with the decline of reimbursement rates, optimization of medical billing processes is key to improving your bottom line.  Robotic Process Automation is leading the way to automate many of the manual tasks associated with reimbursement interruptions and can typically be applied without the additional expenses of outsourcing or a complete software overhaul.  You may have the ability to utilize RPA with your current software vendor without knowing it!

If you enjoyed this post, you'll love our email updates!

Receive content on industry topics, upcoming webinars, current healthcare trends, and more!