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Automation can standardize RCM workflows and provide price transparency


To keep up with consumer demands, practices need to capitalize on the opportunity to digitize their revenue cycle processes self-service technology and automation.

ai in healthcare

Given CY 2020’s Hospital Price Transparency Requirements, which take effect January 1, 2021, there has been a huge push in the healthcare industry to not only provide financial clarity to patients, but also deliver on rising overall consumer expectations in order to stay competitive. While price transparency requirements don’t apply to physician practices just yet, the shift toward transparency and overall consumerism will affect providers because the way their patients approach their healthcare experience will be entirely different.  

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Because the revenue cycle encompasses patient touch points across the continuum of care it must be standardized in order to create the consistency needed to optimize the patient experience and increase patient revenue. This article will look at ways practices can utilize automation to not only meet consumer-driven transparency demands, but also serve three key objectives of most physician practices: 

  • Optimizing the patient experience,

  • Lowering costs of operations, and

  • Increasing revenue collected and lowering bad debt expense 


Digitizing the Revenue Cycle to the Patient’s Delight

Today’s patients want more control. They want self-service options that allow them to manage their own appointments and make payments easily online. They want to know how much services will cost, have the ability to receive care sooner rather than later, and not be surprised when they receive their final bill. While these features are commonplace in other industries like air travel, retail, and banking, unfortunately they are often missing from physician practices.

By introducing digital self-service platforms, patient-facing transactional processes such as scheduling appointments, updating patient information, or paying a final bill can be radically transformed. Digitization creates an easier, more convenient interface for the patient, allowing them to choose when and how to engage, keep up to date while on-the-go, and always feel connected to the practice. 

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Additionally, digitization provides a level of personalization, which will elevate your patients’ experience even further. For instance, data algorithms can determine a patient’s preferences for how to check in and make payments, and then offer these preferences to patients at the right time in their care journey, giving them the tailored, expedited experience they want while also streamlining staff’s work. 


Using Automation to Realize Revenue Faster and at a Lower Cost

One of the biggest advantages automation brings to the revenue cycle is operational efficiency. Many practices still take a manual approach to the revenue cycle, managing patient information through outdated forms and esoteric spreadsheets. With automation technology, complex revenue cycle tasks can be modeled into digital workflows, executed seamlessly and quickly. A simple example is the claim editing and submission process. Automation tools can segment claim holds and edits, evaluate their deficiencies, correct them, and submit clean claims-all tasks that would have previously required staff time and attention. By utilizing automation, practices can simplify work, eliminate costly errors, and accelerate processes that are critical to cash collection. Ultimately, this means more hours of practice staff’s precious time are able to be focused on patient care.

Teaching your practice to work in this standardized manner and adjust workflows when needed to increase efficiency is just as critical as implementing the technology. Relieving your practice of repetitive tasks and removing activities that cause points of friction, failure, and inefficiency will enhance overall operational performance and allow your current staff to focus on more customer-oriented tasks that require a higher level of service. 


Being Transparent Has Never Been So Important 

With 57 percent of Americans having been surprised by a medical bill1, there’s a clear need for both hospitals and physician practices to educate patients on their financial responsibility. As hospitals begin to disclose pricing and estimates, patients will expect the same from physician practices. 

Given the growing complexities of healthcare, maintaining an accurate and up-to-date inventory of costs for services will be challenging for many practices. With a digitized, automated revenue cycle, practices can leverage their data for accurate cost estimation, and can provide pricing information to patients in a clear and concise way. By integrating these tools within your revenue cycle, estimates can easily be generated, and accurate pricing information can continually be made available to patients whether they are researching services on your practice’s website or receiving an estimate at the time of service. 

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Being able to provide real-time financial information and counseling to patients allows them to make better financial decisions which ultimately ends up benefiting your practice in the long run. An analysis by R1 RCM found that patient collection yield increased by over twenty percentage points when potential out-of-pocket costs were clearly articulated prior to service.2


Seizing Opportunities with Technology

To keep up with consumer demands, practices need to capitalize on the opportunity to digitize their revenue cycle processes self-service technology and automation. For successful long-term results, consider how a revenue cycle partner might enable a comprehensive approach to digitally transform the revenue cycle. If your practice can utilize automation to deliver the best possible experience from scheduling all the way to paying the final bill, your organization is bound to see an uptick in revenue, as well as a delighted customer base much more likely to visit your practice again. In short, digital transformation of the revenue cycle offers a competitive advantage that you may not want to wait any longer to achieve.

Joe Polaris, MBA, is senior vice president of product and technology for R1 RCM.



2019 Commonwealth Fund Health Insurance in America Survey, https://www.commonwealthfund.org/publications/issue-briefs/2019/sep/what-do-americans-think-health-coverage-2020-election

Based on R1 RCM proprietary data.

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