Revenue Cycle Automation: How To Get Started

The healthcare landscape is evolving rapidly, demanding innovative solutions from organizations. Revenue cycle automation, a rising star in this transformation, is gaining significant traction. In this guide, we'll take you through the essential steps to embark on your journey with revenue cycle automation.

Understanding RCM Automation

Revenue cycle automation is a game-changing approach that uses technology to streamline and automate financial processes within healthcare organizations. These tasks include financial clearance, claims processing, payment collections, and more. What is the main goal of revenue cycle automation? To increase efficiency, reduce errors, and accelerate revenue generation.

The Benefits of RCM Automation

Embracing revenue cycle automation is no longer an option but a necessity for healthcare organizations. Here are a few reasons why integrating RCM automation into your operations matters:

Improved Efficiency

Automation reduces repetitive tasks that stretch workforces thin, freeing up staff for more strategic and patient-focused work.

Enhanced Accuracy

Automation minimizes human errors, ensuring precise data handling and accurate financial transactions.

Faster Revenue Collection

Automation streamlines financial clearance, claims processing, and payment collection, improving revenue collection and overall financial health.

Cost Savings

Automating parts of the revenue cycle reduces operational costs related to manual processes allowing for better resource allocation.

Patient Satisfaction

Improving financial clearance, which may delay care, and reducing billing errors through automation will lead to higher patient satisfaction.

Assessing Your Organization’s RCM Automation Readiness

Before implementing revenue cycle automation, it's essential to assess your organization's readiness. Here are some basic factors to consider:

People

Each automation is unique and presents its own challenges. Does your organization have the expertise and capacity to design, build, and maintain an automation solution?

Process

Building and maintaining automation requires coordination across multiple stakeholders. Do you have a process to vet ideas, make technology decisions, and support the project?

Technology

Automation will require multiple types of technology, the most important being an automation platform. Does your organization have an automation platform available?

Choosing the Right RCM Automation Solutions

Selecting the ideal automation solution is a critical step in your journey. Key factors in your decision-making process should include:

Vendor Reputation

Research and select reputable revenue cycle automation solution providers with a proven track record in the healthcare industry. Consider their security and encryption standards when evaluating.

Cost-Effectiveness

Assess the return on investment (ROI) of the selected revenue cycle automation solution to ensure it aligns with your organization's budget.

Integration Capabilities

Choose solutions that seamlessly integrate with your existing systems to avoid disruptions in your workflow.

Scalability

Ensure that the chosen solution can grow with your organization's evolving needs.

Implementing RCM Automation: A Step-by-Step Guide

Once you've assessed your organization's readiness and chosen the right revenue cycle automation solution, it's time to set the wheels in motion. Here's Tarpon Health’s proven step-by-step guide:

A diagram showing the phases of the revenue cycle automation lifecycle.
  1. Identify

    • Create a pipeline of automation use cases

    • Estimate ROI and complexity

    • Prioritize for impact

  2. Design

    • Thoroughly document the foundational process

    • Plan and choose a technical approach

    • Create and validate automation inputs

    • Complete design for development

  3. Build

    • Optimize upstream processes

    • Develop code

    • Manage exceptions, risks, and issues

  4. Test

    • Complete the five phases of testing: Unit, Integration, User Acceptance, End-to-end, and Operational

    • Deploy to production

  5. Maintain

    • Establish analytics to measure automation efficacy

    • Integrate automation into ticketing and support

    • Set cadence for quality assurance reviews and system upgrades

Measuring the Success of RCM Automation

To evaluate the success of your revenue cycle automation, monitor key performance indicators (KPIs), including:

  • Claim Denial Rate: A decrease signals improved claims processing efficiency.

  • Days in Accounts Receivable: Reduced days signify quicker revenue collection and better cash flow.

  • Collections Rate: An increase indicates improved revenue generation.

  • Patient Satisfaction: Gather patient feedback to ensure billing and claims meet their expectations, boosting satisfaction.

Conclusion

Revenue cycle automation is an approach for healthcare organizations to streamline financial processes, improve accuracy, and accelerate revenue collection. By understanding the basics, assessing readiness, choosing the right solutions, implementing them effectively, and measuring success, your organization can embark on a successful revenue cycle automation journey.

Should you seek guidance or further assistance on RCM automation, Tarpon Health, the revenue cycle automation community, is here to support you. Tarpon Health is more than a community; it's a catalyst for internal automation capabilities, uniting healthcare organizations through roadmaps, resources, and peer collaboration unmatched elsewhere. Your journey towards automation excellence begins with Tarpon Health.

Previous
Previous

6 Powerful Ways to Automate Your Revenue Cycle Management