Automate your medical billing

Automation solutions for Medical Billing

Build an automated medical billing system with the full power of Robotic Process Automation and streamline your Revenue Cycle.

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A PROVEN medical billing AUTOMATION PARTNER:

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Automation solutions for Medical Billing

Build an automated medical billing system with the full power of Robotic Process Automation and streamline your Revenue Cycle.

Get in touch
See RPA for healthcare in action!

A PROVEN MEDICAL BILLING AUTOMATION PARTNER:

The healthcare industry is facing a great change. One one hand, the need for costs optimising is more urgent than ever before. On the other, in the new, post-pandemic world, patients expect even faster and high-quality customer service. Medical billing and coding operations are playing a crucial role in delivering both.

Biggest challenges for efficient medical billing in the healthcare industry:

Ineffective outsourcing and offshoring

Outsourcing medical billing often leads to the lower work quality, higher denial rate and lower your level of control over the whole billing process.

Incompatible systems & legacy software

Healthcare providers rely on old, inefficient medical billing systems and applications that in many instances cannot be easily integrated via API.

Late payments

Timely payments are crucial for the satisfaction of your patients and for keeping a healthy bottom line in your company.

Medical coding errors

Coding errors are one of the most common reasons for claims denial. From incomplete information to incorrect diagnosis codes, encoding claims manually is simply inefficient.

Manual management and tracking

Manual billing and tracking bills can be a headache and it creates the situation when costly mistakes happen: data get lost and documents get misplaced.

Compliance violations

Non-compliance with HIPAA and other legal frameworks may lead to high fines and, in extreme cases, criminal charges.

Streamlining medical billing with Robotic Process Automation

Medical billing is the most crucial element of Revenue Cycle Management as it can yield a significant impact on a company’s bottom line.

RPA can be used in nearly every step of the medical billing process to help automate and standardize routine and inefficient tasks. It can be leveraged to build complex, end-to-end billing workflows. ​​RPA works at the presentation layer, integrating with all applications and systems, including legacy systems, without creating disruption. It is entirely scalable according to necessities and has up to 100% robotic accuracy.

What elements of the medical billing process can be automated?

  • Patient registration

  • Superbill creation

  • Claims generation and submission

  • Adding relevant ICD codes

  • Payment accessibility

  • Patient’s eligibility check

  • Monitoring claim adjudication

  • Patient statement preparation and follow-ups

  • Providers license & NPI data verification

  • Denial management

  • …any other part of the process you can think of!

Why Robotic Process Automation for Medical Billing and Coding?

Tap into huge automation potential

Medical billing and coding include complex and work-heavy processes which are also very ruled based and repetitive. These factors make the industry players perfect automation candidates.

Free up manpower and focus on patients

Free your employees from performing repetitive tasks that take a lot of time and don’t bring additional value. Let them focus on more meaningful work and building stronger relations with your patients.

Benefit from existing industry standards

The medical billing processes are the same throughout all the US. We have already implemented and tested a number of automations in the medical billing industry and they will work for you as well.

Discover and streamline your operations

Let us audit your processes and tell you what can be done. You will be surprised how many tasks can be easily done by our software robots!

Considering automating your medical billing? Schedule a free consulting session with Flobotics.

  • Higher efficiency, lower operational costs—it’s hard to think of a better way to pique any business owner’s interest in just five words. This phrase also happens to be a pretty accurate description of the benefits of Robotic Process Automation (RPA).

    The promise of handling the manual and repetitive but essential tasks speak to the imagination, convincing more and more organizations to hire RPA developers. To no one’s surprise, massive demand has led to the industry’s rapid growth, projected at over 38% per year, and to the emergence of new tools.

    Blue Prism, Automation Anywhere, UiPath, Power Automate… These are just three of dozens of major RPA platforms out there. And that’s a good thing—competition spurs improvement, forcing each RPA provider to go the extra mile with their product.

    All that sounds great, but there’s one major headache: with so many different RPA vendors out there, which one should you choose?

    Today, we’ll investigate UiPath and Blue Prism, two of the leading RPA solutions. We’ll go through their respective strengths and weaknesses and see how they fare from the perspective of businesspeople and tech folks. The goal is to answer the ultimate question: should you choose Blue Prism or UiPath?

    UiPath

    UiPath is an RPA tool from a Romanian company specializing in process automation. The first version of the platform launched in 2013, and since then, the tool has occupied the top position in the RPA market. Designed to automate manual and repetitive back-office tasks, UiPath offers users access to pre-built automation components that can be leveraged and enhanced to streamline routine processes. Agile, modern, and user-oriented, it is especially popular with business users (it ranks #1 in Gartner’s RPA Peer Insights ratings).

    By now, the platform has expanded into a broad ecosystem of products and services that span low-code application development software, AI orchestration, document management automation, chatbot builder, and lots of other useful tools. Over the years, UiPath has built a name for itself and garnered a large and active user community. There are a couple of reasons for that:

     

    Automation Hub

    You may have dozens of automation ideas from all kinds of people within your organization. That’s a good thing, but it all can start going downhill if you don’t prioritize and control how these ideas are implemented.

    Designed to serve as a cornerstone of all automation pipelines, Automation Hub was created to prevent that. It’s a tracking and management panel that allows you to take the front seat during RPA implementation and prioritize opportunities and ongoing automation tasks.

    Process Mining

    While some companies struggle with catching up with the plethora of automation ideas, others have difficulty identifying them. Process Mining helps you discover automation opportunities by looking into current processes and turning that knowledge into improvement insights. But, it doesn’t stop there—once a process is optimized, Process Mining monitors it to see how impactful the automation was.

    Community

    Everyone loves good tools, especially when they can handle your most mundane tasks! UiPath has thousands of devoted and involved users thanks to its popularity and quality. As a result, there’s always someone to ask for help, and it’s easier to hire UiPath developers than specialists proficient with other RPA platforms.

    The company realizes that its user base is a massive asset and puts a lot of effort into engaging with customers through its c. Hence, the community forum, free, time-limited Community license, regular updates, self-learning resources, and insider previews show that UiPath gets its users.

    Task Capture

    Process documentation is just as crucial as it is difficult—and boring—to create. To serve its purpose, it needs to be consistent, understandable, and not too detailed.

    With Task Capture, you can easily create and edit workflow diagrams or record the entire process step-by-step. You can then save documentation in one of many formats available or upload it directly to Automation Hub. Neat!UiPath—disadvantages

    UiPath—disadvantages

    The perfect RPA tool doesn’t exist, and even though UiPath gets pretty close to it, it has one significant disadvantage: pricing.

    The initial license price is very attractive but does not include all modules. As a result, the costs can quickly increase if you decide to get them all. To reach ROI, smaller companies may need to be more careful about extra functionalities or hire RPA consultants to help them choose the most beneficial ones.

    Blue Prism

    Founded in 2001 in Great Britain, Blue Prism is the oldest RPA tool on the market, and a de facto pioneer in automating large, complex business processes. Coming from a corporate background, it is more enterprise-focused than its contestant, and it’s strongly embedded in the concept of supplying the digital workforce to businesses. BluePrism supports any platform including Java, web, Windows, and can automate virtually any task and application.

    With more than 20 years in the automation industry, the company constantly leverages its experience to improve its mature and widely used platform. One of its biggest assets is high reliability and scalability, essential for a tool widely used in an enterprise setting. It is also worth noting that Blue Prism can be deployed in any environment (including staging and testing). Let’s see what else makes it an RPA tool of choice for brands like EY, Accenture, Microsoft, IBM, Google, Jaguar, Siemens, and hundreds more:

    Enterprise focus

    For Blue Prism, medium and large enterprises are the main target due to the platform’s scalability and reliability features.

    Blue Prism is well suited to accommodate a large number of bots running at the same time without any impact on their performance or stability. Process modules can also be easily reused, enabling fast automation adoption within a department.

    It’s also worth noting that Blue Prism only offers unattended automation. So while it excels at logic-based back-office tasks, it won’t aid individual employees in their everyday work. That is one more proof that Blue Prism tries to focus on corporate clients.

    All-in-one platform

    Designed primarily with enterprises in mind, Blue Prism offers a comprehensive product portfolio to meet every automation goal. It can be used to facilitate and streamline all workforce activities, no matter how complex they are. The platform covers all intelligent automation capabilities, from data gathering, aggregation, and analysis, through visual analytics and machine learning, to automated collaboration and enhanced problem-solving. The number of processes to be executed by the tool is also unlimited. 

    Debugging tools

    Finding the source of a problem is the first step to fixing it. Therefore, efficient debugging features are extremely useful in RPA, especially in complex, multi-stage workflows.

    Blue Prism is equipped with one of the best debuggers out there. The main advantage lies in its dynamic capabilities—developers can interact with the process and alter variables while the debugging is executed. It makes it much faster and more convenient to test various scenarios, ultimately leading to better overall stability.

    Blue Prism—disadvantages

    We’ve just told you that UiPath’s biggest flaw is its price, but Blue Prism isn’t exactly a cheaper option. On the contrary, its implementation can be more expensive in the short run, even more so if you don’t plan to use UiPath’s advanced functionalities.

    Another disadvantage is low engagement with the community. Despite its long-time market presence, Blue Prism acts very slowly when implementing features requested by its users.

    Blue Prism or UiPath: which one’s better?

    Now that we know the two tools’ main strengths and weaknesses, let’s check how they fare compared to one another, tech- and business-wise.

    The tech perspective

    First, the tech stuff.

    • App integration — although both platforms can be integrated with popular desktop apps like Word, Excel, and internet browsers, Blue Prism only supports back-office automation and hence lacks the most crucial front-office apps.
    • Debugging — while UiPath also has its own debug tools, they lack the dynamic adjustment capabilities of Blue Prism.
    • Education — we’ve already mentioned how UiPath encourages its users to get involved with the platform. One of the ways it does it is by giving them access to a rich collection of learning resources and certifications through a dedicated UiPath Academy portal. It is a hub for all skills RPA where anyone can learn how to build automation workflows and dig into the subject. Additionally, UiPath offers a free Community Edition that new learners can use to practice. Unfortunately, the same can’t be said about Blue Prism, which offers certification programs but doesn’t get near the scope of UiPath’s educational efforts. Which also affects…
    • Talent pool — since UiPath does so much more to teach its users how to use their RPA tool, more certified UiPath developers are available for hire than in Blue Prism’s case.
    • Task recording — Recording is an optional feature in UiPath Studio that lets the algorithm capture users’ on-screen actions and recreate them into automated sequences. Blue Prism doesn’t offer any similar functionality.
    • Coding knowledge — Both tools are equally user-friendly for citizen developers as they don’t require coding knowledge to operate (although familiarity with HTML/CSS helps). Still, professional developers add a whole different dimension to what can be done with the platforms (more complex use cases, faster app delivery, smoother operation of the developed automation). One difference is that UiPath is very transparent about its code and allows professional programmers to use C# expressions everywhere, while Blue Prism uses its own, very accessible, language.

    The business perspective

    Of course, successful RPA implementation isn’t just about the technicalities. Business needs are just as important.

    • Costs — UiPath requires a lower upfront investment than Blue Prism, making it a preferable option for startups and smaller companies. Additional features can be added as the company grows.
    • Accessibility — UiPath can be accessed from both a mobile and desktop app, as well as through a browser. Blue Prism is only available as a desktop application.
    • Tasks — unlike UiPath, Blue Prism is limited to unattended bots. These are great for back-office jobs and reducing operating costs but won’t do much for assisting your specialists on-demand. For instance, accounting can make use of both types of bots.
    • Enterprises — Blue Prism makes more sense for corporations and large organizations due to its enterprise focus and good scalability features.
    • Industry — over the years, both vendors have built an impressive track record across different industries. But, in the end, it boils down to the scale. For example, hospitals and clinics may prefer to go for UiPath, but Blue Prism may be a better choice for international healthcare providers

    The verdict

    As you can see, there’s no clear winner in this contest; and there doesn’t need to be—every company has different needs and requires various tools.

    At Flobotics, we understand that and always consider the specificities of our clients. Therefore, even though UiPath is our number 1 RPA platform, we believe every solution, including Blue Prism, has advantages.

    If you’re looking to automate your processes but aren’t sure whether Blue Prism or UiPath will work best for you, you’ve found the right people for the job. Get in touch and tell us about your organization—we’ll handle the rest.

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    Bart Teodorczuk

    RPA Tech Lead at Flobotics. Automation consultant expert for the healthcare and finance industry.

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    UiPath and BluePrism are two RPA giants with decades of experience in the automation industry. Sounds great, until you have to choose between them. What are their strengths? What are their weak spots? And, most importantly, which one’s better for you? You’ll find all the answers on the Flobotics blog

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Considering automating your medical billing? Schedule a free consulting session with Flobotics.

How RPA Can Improve Your Medical Billing Processes?

What is RPA for medical billing?

RPA is a buzzword that you might have heard about multiple times but what does it literally & practically stand for? RPA stands for Robotic Process Automation which by definition is simply creating a software robot (sometimes referred to as a bot) that can perform redundant or repetitive tasks instead of a human with minimal to no interaction with the user. After the robot is programmed using one of the RPA software platforms like UiPath or Blue Prism, it can be easily scheduled to perform a specific list of actions at a specific time or when another event takes place.

Numerous highly sensitive client encounters occur in the healthcare business, but there are also many time-consuming, repetitive procedures and administrative duties that do not require specialist knowledge. From front-office activities to operational operations to patient engagement and bill payment, RPA can automate jobs across small & medium enterprises as well as corporations.

According to Gartner, “50% of US healthcare providers will invest in RPA in the next three years.” Gartner continues, “Healthcare providers are caught in a perfect storm of shrinking payments, improving outcomes, enhancing experience, and bolstering credentials. Any technology implemented to help these providers improve delivery and streamline operations must also optimize costs.”

What are the benefits of automating your medical billing processes with RPA?

1. Reductions in processing costs

If we look into applying RPA at a hospital that, for instance, is required to boost its operational control, we can see that this actually can improve the patient’s experience. By automating revenue cycle tasks like claims and billing, for example, the cost and/or time needed per claim will be significantly reduced.

2. A more efficient billing cycle

RPA can automate accounts payable and data digitization operations, resulting in increased billing efficiency. Healthcare organizations may save considerable labor and financial resources by improving administrative operations.

3. Reductions in the cost of human labor

Healthcare practitioners save time by delegating labor-intensive activities to robots. They can put these extra time resources to better use, such as focusing on more fine-grained patient attendance rather than monotonous data input, allowing them to improve their clinical training.

4. Employee satisfaction improved

This is a side effect of the prior advantage. And the good effect causal chain doesn’t end there! Pioneers in the transformation of healthcare to a digital business claim that a higher degree of job satisfaction among healthcare professionals is strongly connected not just to better patient care, but also to higher corporate ROI.

5. High-quality healthcare

Perhaps the most important and all-encompassing benefit of using RPA in healthcare. Automation enhances patient satisfaction by reducing time, removing the possibility of human mistakes, and allowing staff to focus on more meaningful, patient-centered tasks.

Increased operational efficiency may also broaden the scope of healthcare’s usefulness. As a result, the healthcare system might better meet the requirements of a larger number of individuals. The prospect of sufficient treatment for an increasing number of individuals elevates RPA in healthcare beyond a simple option.

Payroll and time attendance, for example, are activities that may be automated to save up time for personnel in an HR department. You can see an RPA demonstration of automating these operations in the video below.

What can be automated with RPA to improve revenue management cycles?

Medical Billing Processing

Manually processing medical billing operations such as payment posting, Electronic Health Records (EHR), and claims administration takes time. Robotic Process Automation streamlines and automates these operations, enhancing revenue cycle management for medical billing companies’ bottom lines.

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‍Payment Posting

Automated payment posting boosts productivity and eliminates the need for human insurance payment processing. Users may define as many bespoke and detailed rules as they like with this bot. Organizations may educate the bot to post payments in the same manner as they would a new employee. These bots may also highlight unpaid claims for more labor and appropriately submit refunds or takebacks.

Revenue cycle departments have been able to automate up to 70% of the back end of the medical billing process by integrating payment posting bots and even patient collecting bots, enhancing efficiency and lowering operational expenses.

EHR Automation

RPA bots fill in EHR forms and replicate essential data across multiple systems, decreasing human error and allowing doctors to spend more time with their patients. You can automate sending data between one EHR and another, as well as pull the data from your existing EHR to your CRM, etc.

Claims Administration & Submission Process

Human mistake is a common cause of first claim denials in claims administration. RPA bots automate a variety of claims administration operations, including charge entry in medical billing, payer rule checks, and submission.

Boost Patient Communication

RPA bots create an email that summarizes information about the pricing of a service or other consumer inquiries mentioned during a phone conversation. Reminders can also be triggered via bots (I.e., emails & SMSs).

Accelerate Cost Estimation

RPA bots help healthcare businesses automate benefit retrieval and cost estimation operations by simply linking the patient’s profile with the medical services provided and calculating the cost using the price list already available in the database.

Minimize Manual Data Entry

RPA bots aggregate data from many systems and send it into a single patient accounting system, reducing the need for manual data entry. OCR is also used to extract data from images & PDFs in an efficient and error-free method to be plugged into the system automatically.

Automate Claim Denials

Bots can automatically address any simple errors and then resubmit the claim. For more complex errors, the denial can be passed to a human but will provide detailed patient information and denial information, greatly speeding the rework time. As RPA bots take responsibility of denial management in a step-by-step procedure, staff may focus on more complicated denials.

Assist Pre-Authorizations

The revenue cycle of robotic process automation allows healthcare businesses to get data from different websites and systems and integrate it directly into the Hospital Information System (HIS). In some situations, it also applies to pre-approvals.

Integrate Third-Party Applications

RPA bots function as a middleman between disparate third-party tools, allowing data to be shared and processed without the need for human interaction.

Improve the Consumer Experience

Healthcare firms are increasing the consumer experience by utilizing RPA-driven internet chatbots to answer simple questions. Except for managing the chatbots, RPA is able to improve the speed and quality of response on other sources.

What are the steps of implementing RPA to improve medical billing?

1. Perform process audit and validate requirements

Businesses should devise a strategy for selecting the best processes and then prioritizing them based on factors such as complexity and return on investment. Consider how automating these activities will appear, what it will accomplish, the business context in which it will be used, and how it will fit into future business operations or the broader automation journeys. During this step, RPA consultants will map your processes, review your current tool stack and compare them with your business goals and requirements.

2. Perform Feasibility Assessment including process discovery & even legal compliance check

Perform a feasibility analysis for each process to see how much of it can be automated. This is a two-step procedure that involves examining the process and determining technical viability. This assessment should be carried out by the operation user, an SME (Subject Matter Specialist), and an RPA expert.

3. Readjust

Determine whether procedures are not organized, standardized, optimized, documented, or implemented as anticipated based on the feasibility assessment study. Attempt to reoptimize and reorganize the process at this point.

4. Gather User Stories

A user narrative defines the aspects of an application that will be constructed from the perspective of the end-user. It goes through all of the user needs in great depth. It’s also critical to have a thorough description of each operation that will be automated. Develop a process description document with defined RPA processes for the development team based on this information.

5. Start Development Process by setting up the environment

The development process begins at this step, depending on the RPA workflows that have been developed. Using RPA technologies such as UiPath, Blue Prism, and others, the developers generate automated scripts and program code. Because each RPA tool has its own set of capabilities, firms need to be very particular when selecting the right solution for their purposes.

6. Test RPA Process via a PoC before live deployment

Conduct extensive testing to examine performance in all conceivable circumstances and to identify faults when the procedure is run. Send any possible performance or bug concerns to the development team for resolution.

7. Reconfirm & Deploy

Once the development teams have rectified the first tests and problems, double-check the results, and deploy the entire RPA solution.

RPA in medical billing – what should you remember?

Are you in the process of implementing RPA in medical billing already? Here are 5 things you should keep in mind:

Select the right RPA technology vendor

There are different RPA technologies (such as UiPath, Blue Prism, Power Automate, Kofax, and more) available on the market, providing various levels of efficiency, licensing costs & features. Depending on your business requirements some technologies may be more suitable for your needs than others. Make sure to consult that before jumping straight to RPA development!

Bet on the right developers

Following the same approach above, recruiting skilled RPA developers is crucial. The developers must have the relevant technical skills and experience for being independently able to set upset-up the environment and actually create the automation workflows with the minimum downtime. This skilled personnel can finalize the project and keep the possibility of scaling up in the future when needed.

Ensure legal compliance

All created workflows & bots must be legally compliant with each local market (i.e., compliant with HIPAA’s 3 rules in the US)

Select the right process

Process Selection for automation requires the right skills to define what is actually needed and what tools and development/testing methodology is required to achieve the required business automation needs.

Follow the right KPIs

KPI Selection is based on the business needs which differ based on the required outcome from this project. An example here would be RPA KPIs Selection including but not limited to: increased productivity, ROI, reduction of downtime, and others.

Conclusion

What we really believe in is that each market/firm/entity has its own business needs which need to be tackled from a completely independent angle to identify the real requirements, KPIs, the environment needed & expected outcome from the RPA deployment. Full-scale assessment should be done by adequately qualified & experienced personnel to avoid any loss in time and/or money as well as keep a chance for expansion and scaling-up in the near future.

Looking for an RPA consulting services or RPA development partner to automate your medical billing? We are a team of industry-experienced experts, we are 100% HIPAA compliant, and we have delivered various RPA development for the healthcare sector. Reach out to us and get a free consultation for your medical billing processes.

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