Revenue Cycle Automation In Healthcare

Hospitals are looking for ways to cut costs and improve efficiency, and many are turning to automation as a way to do that. Automation has the potential to transform the revenue cycle, enabling significant improvements in accuracy, speed, and cost savings. However, not every hospital will reap major benefits from automating its revenue cycle. Several factors must be considered when deciding whether or not automation is right for your hospital. Some of these factors include the size of your hospital, the complexity of your billing process, and the level of automation already in place.

Regarding revenue cycle processes, there are many different options available. One option is to purchase a software package. This can be a good solution for hospitals that do not have the internal resources to develop their own automation solution and end up saving them thousands.

Missteps Threaten Automation ROI

Automation technology has long been a secret of the manufacturing sector. By reducing dependence on human workers, who are often error-prone and require expensive benefits, automation is supposed to help manufacturers improve efficiency and reduce costs.

However, recent evidence suggests that automation may not be living up to its potential. A study by the Boston Consulting Group found that nearly 60 percent of companies surveyed had failed to achieve their desired ROI from automation investments.

The biggest reason for this failure was inadequate planning; in many cases, companies simply did not have a clear understanding of how they wanted to use automated technologies or what sorts of benefits they were hoping to achieve. As a result, they could not implement automation in a way that integrated seamlessly with their existing operations.

In other cases, companies ran into problems because they did not have the right mix of humans and machines. To realize the full benefits of automation, companies must take a more strategic approach, carefully mapping out their desired outcomes and ensuring that they have the right team behind them to make the most of their investment.

The IA Ecosystem And Why It’s Important in RCM Automation

The IA ecosystem is essential in RCM automation for several reasons.

  • First, it provides a consistent and reliable way to manage accurate data.
  • Second, it helps reduce data management's complexity by providing a unified interface for healthcare revenue cycle management.
  • Finally, it helps improve data management efficiency by automating tasks such as manual data entry and validation.

As a result, the IA ecosystem is an essential part of any RCM intelligent automation solution. Providing a consistent and reliable way to manage data helps to reduce the complexity of data management and improve the efficiency of the overall business processes. Doing so helps improve the quality of care for patients and helps healthcare organizations save time and money. Thanks for reading! I hope this has helped you understand the importance of the IA ecosystem in RCM automation.

If you want to learn about the benefits of Outsourced Healthcare Revenue Cycle Management or the Revenue Cycle Automation strategy? Visit Enter Health now and get all the information you need.

How The Revenue Cycle In Accounting Can Be Automated?

The revenue cycle in accounting begins when the bill is sent. Whether this bill comes from an order or a contract, each will ultimately drive the billing. 

Contract To Invoice

Automating a revenue cycle can refer to a system that enables human resources as they receive the contract, put together an invoice, and send it to the customer. Maybe the system allows you to set rules for recurring invoices, or it might pre-populate some of the information into the invoice.

Invoice To Customer

Once created, invoices are sent to the customer. Communication may be through any number of channels:

  • Email
  • Electronic Data Interchange (EDI)
  • Applications

Cash Remittance

Revenue cycle applications can allow payment to be remitted directly to accounts receivable. Once payment is received, invoices are marked as paid, and the system is updated automatically and in real time. The customer is given plenty of convenient, quick options that drive payment timeliness.

Collections

Collections, however, are one complex area for software. When the bank receives checks, they do not communicate what invoice was paid, only what payment was received. This presents some challenges to automation. But dont worry, Enter has solved this problem.

Tools To Automate The Revenue Cycle

In the business world, time is money. The faster you can get a product or service to market, the sooner you can start generating revenue. However, the process of taking a product or service from conception to customer can be complex and time-consuming. Thankfully, there are now several tools available to help streamline the revenue cycle and get products and services to market faster.

Middle Office

The middle office is responsible for a company's financial operations, including accounting, billing, and collections. In the past, these tasks were often done manually, which was time-consuming and prone to errors. Today, there are many software applications that can automate these tasks, freeing up time for other activities.

Building A Business Case For CPQ

Configure-price-quote (CPQ) software is a tool that helps companies quote prices for complex products and services. To make a case for investing in CPQ software, businesses need first to understand the benefits it can provide. These benefits include increased accuracy, improved efficiency, and increased sales. By building a business case for CPQ software, companies can make an informed decision about whether or not it is right for them.

Contract-To-Cash

The contract-to-cash process encompasses all of the activities involved in taking a sale, from contract signing to cash receipt. This process can be complex and time-consuming, but there are now software solutions that can automate many of the tasks involved. By automating the contract-to-cash process, businesses can improve their cash flow and free up time for other activities.

Technologies

Here’s a closer look at three different technologies that are well suited for revenue cycle automation and included in our IA ecosystem:

Robotic Process Automation

Robotic process automation (RPA) is a technology that allows businesses to automate repetitive tasks by programming software robots, or "bots," to mimic human actions. RPA can be used to automate manual, time-consuming, and error-prone tasks in any business process, including the revenue cycle. For example, RPA can be used to extract data from invoices and enter it into accounting software or to populate patient records in an electronic health record (EHR) system.

To learn more about Robotic process automation (RPA) click the link.

Machine Learning And Expert Rules

Machine learning is a type of artificial intelligence (AI) that allows computer systems to learn from data and experience without being explicitly programmed. Machine learning can be used in revenue cycle automation to automate tasks that are too complex for traditional rules-based approaches, such as fraud detection. For example, machine learning algorithms can be used to analyze claims data to identify patterns of fraud or abuse. 

Optical Character Recognition & Natural Language Processing 

Optical character recognition (OCR) is a technology that enables computers to read text from scanned documents or images. Natural language processing (NLP) is a type of AI that allows computer systems to understand human language. Together, these technologies can be used to automate the process of extracting data from unstructured sources, such as scanned invoices or medical records. For example, OCR can convert a scanned invoice into text, and NLP can extract relevant information, like the name of healthcare providers or the patient's account number.

Revenue Cycle Automation Is Perfectly Suited For

  • Benefit and Eligibility Checks: A software solution can automate the process of verifying patient benefits and eligibility, which can help reduce denials and improve cash flow.
  • Prior Authorization Management: A software solution can automate obtaining prior authorization from insurance companies, which can help reduce denials and improve cash flow.
  • Vendor Contract Management / Contractual Analysis: A software solution can automate the process of managing vendor contracts and conducting contractual analysis, which can help reduce costs and improve efficiency.
  • Medical Necessity Checks / Clinical Validation: A software solution can automate the process of verifying medical necessity and conducting clinical validation, which can help reduce denials and improve cash flow.
  • Collections / Payment Processing / Write-offs / Adjustments: A software solution can automate the process of collections, payments, write-offs, and adjustments, which can help improve cash flow.
  • Accounts Receivable / Accounts Payable: A software solution can automate the process of accounts receivable and accounts payable, which can help improve cash flow.
  • Fraud Detection: A software solution can automate the process of fraud detection, which can help reduce losses and improve efficiency.

Click here to learn more Benefits of Applying Process Automation

Bottom Line

So, there you have it. Everything you need to know about how automation can impact the revenue cycle in healthcare, as well as some of the challenges that can threaten ROI. As we’ve shown, automating different aspects of the revenue cycle is critical for success, and our team at enter has the tools and technologies to make it happen for your organization. 

Are you ready to take advantage of this powerful technology? If so, reach out to Enter health today for a consultation for White Glove RCM. We would be happy to help get you started on your path to automation bliss!

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