Healthcare is predicted to have a 60% automation potential. This means that close to two thirds of healthcare tasks—especially managerial, back-office functions—could be automated, allowing healthcare providers to offer more direct, value-based patient care at lower costs and increased efficiency.
The industry's main pain points are managing levels of inventory, supporting digitization of patient files, optimizing appointment scheduling, and executing billing and claims processing. RPA has proven to be the solution healthcare organizations need for these pain points in order to redirect their employees to higher-level tasks that drive innovation and deliver a better patient experience.
Better Health IT
Improve Customer Support
& Call Center Efficiency
& Audit Trails
Revenue Down 43-65%
49% decrease in claims
58% decrease in eligibility
New Regulatory and Public Health Requirements
90-120 Day Elective Backlog
By 2025 there will be 2.5 clinicians to 1000 patients in the US
Record number of healthcare layoffs due to COVID19 financial impacts
Automating revenue cycle functions like claims processing, prior authorization, or billing can reduce the average operational cost by 75%. With prior authorization being the most costly, time-consuming transaction for healthcare providers, according to the 2019 CAQH Index report.
RPA can optimally schedule patient appointments according to diagnosis, location, doctor availability, and other criteria. RPA systems can also examine patient data to create a report that can be sent to a referral management representative to aid in fixing an appointment.
RPA can speed up data processing for insurance claims while avoiding human error, avoiding delays & monitoring the entire process. RPA can also identify compliance-related exceptions while avoiding non-compliance of regulations.
By saving time, eliminating the risk of human error, and by allowing the staff to focus on more valuable, patient centered activities, automation improves patient satisfaction.
JOLT has developed a three-phased automation approach to maximize reimbursements from insurance providers, significantly increasing staffing efficiencies, and ultimately reduce and prevent denials and underpayments.
We start by immediately automating the manual analysis work, implementing RPA to review all submitted claims and the amount paid (or not paid) by the insurance provider and flagging any discrepancies.
We focus on prioritization, leveraging RPA to sort these discrepancies by the highest amount owed to the health system. Prioritization maximizes the value for the health system by positioning the workforce to recover as much lost revenue as possible from the insurance providers.
We broaden the scope of analysis even further. RPA determines metrics such as which payors are generating the most denials, which claims were previously paid and are now being denied, the top 10 reasons for claim denial, and how many days each payor spends in accounts receivable (AR). With a clear visibility into what’s driving denials and how to improve future performance, health systems can start collecting more and spending less money than they should. Tracking and recovering revenue puts health systems in a better financial position, enabling them to continue to deliver high-quality care to the people in their communities. Prioritizing revenue cycle automation allows the staff to focus on those higher value-add tasks, and helps the health system improve the speed, consistency, and quality of the care they provide to their patients.