Revenue enhancement and cost transformation opportunities have always existed in the hospital industry due to the fundamental architecture of archaic processes, disparate systems, and a zero-sum financial framework where the provider’s gain is payer’s loss and vice-versa. The COVID-19 pandemic is further straining healthcare provider systems already under pressure from exploding administrative costs, growing staff burnout, and evolving patient expectations. Hospitals and health systems today face unprecedented financial impact as they ramp up services to control the virus spread and save lives, even as they are forced to defer elective procedures – a major source of revenue. It is more important now than ever to challenge the status-quo and drive process transformation and innovation. The time to make a strategic shift in hospital financial process management and embrace Intelligent Automation is NOW.
Deploying Intelligent Automation – a fusion of Robotic Process Automation (RPA), Machine learning and Artificial Intelligence (AI) – can help alleviate the time, effort and money constraints facing healthcare providers in the new normal.
While most healthcare providers leverage RPA across basic functions, the level of automation adoption remains quite low as compared to other industries. Intelligent Automation elevates RPA capabilities by enabling the system to make more complex decisions using not only structured data but also unstructured data. Automating unstructured content processes involving text and images allows the human workforce to focus on high value patient-centric activities such as improving case management, exception handling, and patient care and experience.
For providers, the drivers of success in the post-COVID era revolve around enabling digital transformation in the areas of telemedicine, scalability, interoperability and supply chain. To achieve these objectives, Firstsource offers Automation as a Service (AaaS) across clinical and revenue management value chains, spanning the end-to-end patient journey as well as back office administrative support. From automating core EHR functions, revenue cycle management, contact center operations to automating processes such as prior authorization, patient scheduling, eligibility verification and physician credentialing, our Intelligent Automation solutions and services positively impact revenue, patient experience and employee satisfaction.
Process mining, reengineering & digitization across functional areas.
Design and Implementation services underpinned by Automation COE and Factory.
End-to-end automation services, BOT analytics, exception management.
Challenges: Manual physician credentialing processes and archaic systems that rely on spreadsheets require a full-time credentialing team to fill out extensive paperwork, gather signatures, call/fax other organizations and institutions to verify information. On average, each provider credential application costs $7,000, in addition to 20 hours of administrative time.
Intelligent Automation benefits: Up to 50% reduction in manual effort, 40%-50% lower costs and accelerated
Challenges: Physicians, nurses and clerical staff typically spend 16.4 hours a week on prior authorization requests with up to 9 hours a week lost in waiting for payer responses, leading to high costs and negative patient experience.
Intelligent Automation benefits: Up to 60% reduction in time and effort, 40%-50% reduction in cost of service, faster turnaround, superior patient experience, and deeper insights into upstream and downstream issues for proactive resolution and process improvement.