When you use your local ATM or the self-checkout at the grocery, you realize that automation has been a part of our existence for many years and deploying its use in healthcare is a critical strategy for meeting future goals. As the healthcare industry grapples with value-based care initiatives and the need for further financial cost reductions, automation is receiving heightened attention as a long-awaited way to streamline administrative resources and eliminate waste.
Automation software solutions can be applied to most standardized, repeatable processes and lend themselves particularly well to the healthcare payment lifecycle. Influencing patient access and the Revenue Cycle Management (RCM) functions, automation software can be designed to improve many different aspects of patient billing and relieve the pressure most hospitals and physician group practices are feeling from cost reduction expectations.
How Utilizing Automation Software Reduces Costs
Since 2014, the use of EHR has automated the patient documentation process industry-wide and brought significant savings in paper chart creation, storage, retrieval, and management. In recent years, automation software is being applied to many of the core reimbursement functions with similar tangible results: reduced direct labor costs and improved data analytics, plus reduced A/R days outstanding. Let’s look at where efficiencies can be realized when introducing these types of automated improvements:
- Insurance Verification and Benefits — By verifying each patient’s insurance coverage and remaining benefits in real-time, you know what benefits are covered for the required tests and procedures, and how much to collect prior to their appointment.
- Prior Authorization (PA) — With automated PA, requirements can be determined, submitted, monitored, and followed up with little to no human interaction.
- Medical Coding — Ensuring all codes with correct levels of specificity attached to submissions allow clean reimbursement.
- Denials Management — Currently, up to 65% of denials are never followed up, but with an automated process, follow-up can happen seamlessly, and revenue captured that would have otherwise been abandoned.
Improved Productivity for Providers
In a recent report, 70% of physicians estimated spending one or more days per week managing the administrative tasks that could be alleviated by introducing automation software. These changes would then allow an increase in productive patient appointment time to the equivalent of over $83,000 per year per provider.
With the number of people entering medical school declining year over year due to perceived administrative burdens, maybe physician shortages could be reversed as patient care would once again be the primary function of providers.
Savings in Labor Costs
Recently, 86% of providers stated in a recent AMA report that prior authorizations have continued to increase in the last five years requiring more staff time to administer. This includes employees spending time processing resubmissions and following up with insurance payers manually, as well as placing calls, waiting on hold, and logging on and off of individual payer portals.
By reducing or eliminating the manually intensive tasks that can be better handled with an automated solution, you can redeploy and elevate employees into higher functioning responsibilities. This produces savings directly on labor costs and indirectly on potential hiring and retention activities, as employee turnover is reduced.
Enriched Patient Experience
Anytime your healthcare providers can spend uninterrupted, focused time with their patients; it improves everyone’s experience. Questions can be answered, concerns addressed, and outcomes, as well as patient satisfaction, should improve considerably.
Additionally, today’s patients are actively engaged in the financial responsibility of their care and by providing them with reliable and accurate charges payment can be secured thereby reducing A/R days outstanding and the collection process.
Increased Revenue Capture
Reimbursement is already contingent on contractually agreed amounts from insurance payers that discount fees assigned to services. By automating and streamlining PA, insurance verifications, and claims management, your organization should recognize a significant increase in previously relinquished or abandoned revenue opportunities.
By bringing enhanced automation into previously manual procedures, administrative savings can be recognized in a variety of ways. Additionally, operational insights from data-driven analytics will also routinely point to areas in need of further investigation and improvement.
Schedule a demo today to see the benefits of using automation to reduce administrative costs within your practice.