As healthcare has evolved over the last several years, so has the position of CFO in both hospitals and health provider organizations.  Today’s CFO is responsible for ever-widening areas of responsibility that may include strategic leadership and transformation, post-merger integrations, technology and analytics, and risk management/regulatory compliance.  According to a survey by McKinsey & Company, more than 45% of today’s CFO responsibilities are non-finance related. So how best to succeed in this continually expanding value driver role while still maintaining top-notch financial results and bottom-line strength? By welcoming artificial intelligence (AI), machine learning (ML) and robotic process automation (RPA) that promises to streamline the healthcare billing lifecycle by improving the accuracy and timeliness of many patient/insurance collection functions.

Further Disruption on the Horizon with Robotic Process Automation (RPA)

When Black Book’s 2019 CFO Survey was released, it confirmed what many already knew—healthcare finance will be further disrupted by the demands of growing consumerism and value-based care initiatives, and the CFO role will continue to expand and absorb as a true business partner at the strategic level.

It’s more critical than ever to accelerate and automate the patient access process with the latest technology, as well as explore improvements in the revenue cycle management functions so that revenue is generated, processed, and collected seamlessly and accurately, freeing up leadership to focus on long-range tactical issues.

Where Can Revenue Cycle Efficiencies be Gained?

Ensuring a healthy bottom line is the overall goal of any thriving organization. With healthcare, there is the added challenge of third-party payers that have complex and always evolving processes and guidelines. For example, many in the healthcare field report that the overwhelming prior authorization process creates significant workflow complications, and yet, prior authorizations have the lowest adoption rate of automated options available.

With the availability of AI-driven technology and RPA that can take burdensome and overwhelming manual tasks and perform them efficiently and accurately in real-time, let’s take a look at the ways this technology is utilized in the healthcare setting:

  • Insurance Verification and Benefits Eligibility—Patient eligibility can be tracked and confirmed precisely each time a patient is seen, or if possible, before being scheduled.  Information on coverage, plan specifics, co-insurances, deductibles remaining, and out-of-pocket maximums would all be known in advance, reducing the chance of denials down the road.
  • Prior Authorization—RPA and AI-driven prior authorization technology processes claims when received, automatically follows-up on outstanding approvals, and provides status updates to staff so that patients can be scheduled efficiently, and claims paid unencumbered.
  • Patient Pay Estimation—Allows patients to be notified of their co-pays due prior to their encounter and any money collected or payment plans implemented in advance.
  • Accounts Receivable & Denials Management—With a large number of claims going unworked before or after being denied, bringing an intelligent RCM platform and RPA bots to help predict revenue recover and manage A/R workflow allows revenue previously (often) abandoned to be collected.  Through systematic and extensive payer and clearinghouse integrations, AI and RPA-driven software makes follow-up less cumbersome and more efficient.

As the CFO role continues to evolve and drive strategy, it is imperative to use the resources that are available to streamline the basic healthcare payment lifecycle ensuring strong revenue results and freeing the CFO to participate at the leadership level.  And don’t forget the obvious added bonus to initiating these types of improvements — significant enhancements to the patient experience, as well as staff members available to perform higher-level functions.

Contact us today to see how robotic process automation (RPA) can enhance your organization’s revenue cycle performance at the strategic level.