Revenue Cycle Management (RCM) companies face numerous challenges, including claim denials and cost to collect. It is estimated that up to 40 percent of medical bills contain errors and a report by Advisory Board states that 90% of claim denials are preventable and can be corrected for payment. Claim denial management is a big opportunity for Providers to reduce their Cash Conversion Cycle (CCC).
Reducing claim denials requires a multifaceted approach involving –
Robotic Process Automation (RPA) is a solution to automate rule- based manual tasks and this works in claim processing automation. An RPA BOT can monitor outgoing claims based on a pre-determined checklist. If an error pattern is detected, the RPA BOT can take appropriate corrective action for the claim before it is submitted. For claims that cannot be corrected, the RPA BOT can move them to an exception flow path, where the claim can be queued for manual intervention and correction.
Our delivery team has the added benefit of a clear understanding of US healthcare rules and regulations, alongside specialized RPA engineers experienced in building and deploying BOTs in various parts of Revenue Cycle Management (RCM).
Sandeep heads the Robotic Process Automation (RPA) practice at iNatrix. He has worked on a wide range of technologies such as embedded programming, OS internals, and latest web technologies. In his personal time, he enjoys cycling, and reading non-fiction.