Billing bots can streamline revenue cycle management

Billing processes can be full of tedious tasks that take employees hours to work their way through, from managing denials to confirming patient insurance. New technology known as robotic process automation, or “bots,” are beginning to streamline and speed up these processes.

Randy Notes, Principal at KPMG in New York, NY, says with bots “you get more accurate information accomplished more quickly. Faster, better, at a lower cost.”

These bots can do in seconds what it takes human workers to do in minutes or longer. “The beauty of these bots is one bot can perform multiple duties,” Notes says. “These are, in essence, repetitive tasks, and in some cases fairly predictable tasks. And a bot software can work at light speed, so to speak.”

Notes is already seeing bots used in a variety of ways that can improve the revenue cycle, such as helping to access additional information for denied claims to increase the likelihood that the payer will pay.

A typical employee process requires a series of steps: navigating into the medical record; printing information by PDF to a desktop or server; logging into the payer website; uploading the PDF file; getting a reference number from the payer; and documenting that back into the account.

Notes says: “Our clients take about five to eight minutes to complete that activity. A bot could do it within a couple seconds.”

The technology can help “augment” the work of administrative staff, too, Notes says. “Then you can refocus your staff on more complex, higher value accounts that might require something more of a judgment call,” he says.

With the advent of artificial intelligence (AI), some bots can actually be trained to make judgment calls based on probability. “The question is, whether you feel comfortable enough that you would be willing to let the software make that kind of decision,” Notes says.

Bots could also be helpful at reducing outstanding accounts receivable. “You can never staff down to one penny. There are just too many accounts. So maybe with the use of these bots you can get down to a much lower dollar threshold.”

Additionally, bots would be ideal, Notes says, for very tedious tasks such as sifting through duplicate medical records. The bot would be able to log onto the payer website and pull information on claims status and then bring it back into the host system.

Notes believes they’d also be useful for cash posting and cash reconciliation processes, as well.

And of course, they’d be useful at the point of service. “It could be everything around financial clearance or appointment setting,” Notes says. “[Bots] could help patients pre-populate information to accelerate their sponsorship program, through Medicaid or some other kind of insurance. The bots could run eligibility on all your patients to see if there is insurance available.”

Notes says the industry is excited about the potential for what bots can do. “At the end of the day, either you’re having to pay a third party vendor to do these activities for you, and you’re saving the cost, or you don’t need to hire additional people to cover the entire workload that you have,” he says.

He contends that adding bots is like “extending your workforce with a digital worker that doesn’t get sick, doesn’t have to take FMLA or vacations.”