How Robotic Process Automation Improves Revenue Cycle Management

Kareo has recently acquired PatientlySpeaking, a leader in robotics process automation (RPA). With Kareo’s intuitive billing platform, PatientlySpeaking’s groundbreaking RPA, and the foundation laid by five years of partnership, users will be able to streamline labor-intensive processes like never before.

The PatientlySpeaking leadership team started in RPA technology in the mid-1990s designing bots that revolutionized the telecommunications industry. For the last eight years they have focused on developing RPA bots specific for the medical industry.

If you are in the medical billing field, you have probably been hearing more and more about RPA.

If you haven’t, RPA is a software-based tool that relies on bots to emulate human work, specifically in labor-intensive areas of an organization’s process. Essentially, the bots perform the same work that humans would, using the same interface and following similar steps, which allows businesses to automate repetitive tasks.

Because RPA significantly reduces processing times and, unlike humans, works 24/7, it empowers organizations to process and manage increased claim volumes quickly and accurately. The result is greater efficiency and a much lower cost per claim.

One of the most popular RPA tools leveraged for medical billing is the payment posting bot. This bot allows users to create as many custom and granular rules as they desire. Organizations can essentially train the bot to post payments the same way they would train a new staff member. These bots are also programmed to accurately post refunds or takebacks and can flag underpaid claims for additional work.

By adding payment posting bots and even patient collection bots, revenue cycle departments have been able to automate up to 70% of the back end of medical billing process, improving efficiencies and reducing operations costs.

RPA is also leveraged with integrations. Integrations allow nurses, physicians, medical coders, and billers to access information from other systems more easily. Staff may currently use a variety of different systems for claims, regulations, patient information, and other processes, and integration offers a way to access and combine that data into one platform.

For revenue cycle departments, adding RPA to integrations allows organizations to take information from disparate systems, layer it with established business rules and logic, generate a clean upload of encounters and patient information directly into billing platform, and automate 100% of the front end of the billing process.

If you are wondering if RPA tools are the right fit for your revenue cycle department, consider your answers to the following questions:
  • Can the process be broken down to a set of if/then decisions and business rules? Since RPA tools emulate human work, the bot is essentially programmed with conditional if/then rules. These bots are faster to implement and more cost-effective. Kareo’s PatientlySpeaking RPA tools are fast and easy to program with the ability to scale and grow your custom rules.
  • Is the data accurate and accessible to RPA bots? To maximize efficiency with your RPA tool, it is necessary for the bot to have direct access to accurate data. Kareo’s PatientlySpeaking tools have direct access to the data they are programmed to work.
  • How much total labor time is required in the current process that could be eliminated or redeployed through automation? Pick a process to automate first that has significant potential for gains through automation.
  • How can the application be scaled and implemented across the organization to deliver greater value? This is a very important factor to consider when selecting an RPA tool. Conditional RPA tools should be very easy to customize and scale. Kareo’s PatientlySpeaking RPA tools are prebuilt to interact with the platform, making for quick and easy implementation.
  • Can the automated process incorporate a built-in monitoring system to help mitigate risk if a step is delayed or fails? What is the risk to the business if a step fails? Since RPA tools run independently, without having a failsafe monitor your business runs the risk of not processing the work it is programmed to do. Kareo’s PatientlySpeaking tools offer robust system monitoring 24 hours a day, seven days a week.
If you are interested in learning more about RPA tools, please contact your Kareo sales representative.

About the Author

Michelle is Kareo's Enterprise Sales Engineer. Michelle has been in the medical billing industry for over 18 years as a former CPC, expert witness for the WCAB, and...

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