Robotic Process Automation in Medical Billing – Proof of Concept

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RPA in Medical Billing

We recently release a Bot Proof of Concept for medical offices. The bot POC automation we completed used common software tools portals including Med Office Systems, Simple Practice and Claim MD. These tools are like countless others used by medical offices in the US and around the world. You can find our Robotic Process Automation Proof of Concept video for more clarrification.

How can Bots and RPA Help with Medical Billing?

Medical billing is a four billion dollar business in the United States. Due to the complexity of the healthcare systems with multiple providers, insurance companies, plus patients, the environment can be extremely demanding. All billing processes typically involve a healthcare provider obtaining insurance information from a patient, filing a claim. In many cases it can also involve following up on, and appealing claims with health insurance companies to receive payment for services rendered, such as testing, treatments, and procedures.

The process of handled medical billing can be very manual. Many of the processes are similar but differ insurance company to insurance company, provider by provider and finally by different software and portals that are used in medical offices. Most of these functions are rules based and repetitive and come in high enough volume that looking to RPA and bots to streamline can bring significant cost savings, efficiencies, plus assist with compliance. Because of this, we find ourselves doing RPA POCs for medical offices frequently.

What Did We Automate in Our POC?

The first step in our POC was to log into the practice’s Med Office System software. From there we downloaded automatically and saved for later use reports such as Patient Lists, Provider Lists, and Insurance Company Lists. We then logged into an EHR portal named Simple Practice. From there, we navigate to different tabs and extracted claims information for a patient.

We then navigated back to Med Office Systems and populated patient information from Simple Practice to Med Office Systems. Finally, we downloaded a copy of a claims report from Med Office Systems and uploaded it to Claim MD. Simple right? All those steps are certainly ones that would be monotonous for a human staff worker and ones that would be prone to error over time. It is the reduction of error and the repurposing of people to higher value work that always makes the case to deploy when conducting a bot POC for medical offices.

RPA Deeper Dive

Bots leverage RPA to perform their functions. Bots in a customer facing automation might also use Conversational AI. Let us take a moment to examine RPA. RPA stands for Robotic Process Automation. When we speak of robotic, we are referring to software capable of being configured to do complex tasks and acting like a human. The software instance will read a computer screen by screen scraping it.

It will also be able to copy, and paste information, plus move, and click a mouse, just like a human would do. When we refer to process in RPA, we are thinking of a sequence of steps that are part of a meaningful work function or activity that a human would ordinarily be doing. Finally, when we speak of automation, we are speaking about processes combined with getting all of this done automatically, and without human intervention or oversight.

Repetitive rules based tasks, which are mundane, not changing often, and that happen in high volume are the best candidates for RPA. At Valenta we work with all the leading RPA software providers and can select the best tool for any requirement. The software modules are off the shelf, but need configurations for all the potential task permutations that might be present office to office.

About Valenta

At Valenta, we work exclusively with SMB clients who have not always had access to consultants, developers, and managed service providers to roll out the latest transformational technologies. Valenta also provides additional consulting and services besides those focused on bots, automation, RPA, Conversational AI, and other forms of digital transformation.

We can provide consulting for any kind of business process optimization and can work on other types of business software projects including ERP and CRM. We also provide a wide variety of staff augmentation. We provide staff around digital transformation and business software administration, plus many traditional back office roles. Some of those roles include, accounting, bookkeeping, billing staff, digital marketing, paralegal, medical assistants, and a lot more. If you would like to discuss RPA and determine if it is a fit for your business, we are here for you. If you would like to discuss other types of project or staff augmentation, we can also assist.

Want to Learn More?

Utilizing RPA services and automation provide significant opportunities to reduce costs to a medical practice and increase the productivity of their office staff. Routine lower value work that was formerly done by employees can be replaced with higher value, more cognitive, patient centric, and more revenue focused work. RPA and bots boost productivity and can help any office leveraging them to achieve more, without having to expand their workforce. RPA for small and kjkmid-sized business can be a game changer and digitally transform workflows.

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