RPA in Healthcare

Sample Processes
Billing and Claims Processing

RPA helps healthcare companies in gathering data from various sources and processing the claims accurately and quickly leveraging rules-based decision making.

Patient Enrollment

RPA helps capture patient information at the point-of-service accurately, and updates the information into the revenue cycle system resulting in increased clean claim transmission and timely reimbursement for services.

Eligibility Verification

RPA is used by healthcare providers to get data on patient’s coverage, out-of-network benefits and other insurance information. It helps them submit clean claims, while avoiding claim resubmission, reduce rejections / denials, and increase upfront collections.

Regulatory Compliance

RPA plays a critical role in improving governance and regulatory compliance. It simplifies compliance by keeping detailed logs of automated processes, automatically generating the reports an auditor needs to see, and eliminating human error.

Revenue Cycle

RPA enables healthcare insurers to integrate multiple systems and creating solutions that lookup code changes, ICD-9 code changes, code definitional changes, billing code changes, codes for disease classification, accelerating the revenue cycle turnaround time.

Clinical Documentation

RPA helps healthcare providers in creation of a digital records detailing the medical treatment, medical trial or clinical test, which is accurate, timely and reflects the specific services provided to the patient.

The labor-intensive, expensive and error-prone manual processes involved in the healthcare industry are an operational challenge in delivering better patient care. In the last few years, the healthcare industry has been trying to bring a fundamental shift by extensively deploying RPA and AI solutions to overcome these challenges. The automation of manual tasks is an important avenue for performance improvement as the healthcare industry continually works to cut costs and improve efficiency. RPA has helped accelerate the healthcare process’ efficiency, compliance, cash flow, accuracy and enabled businesses to deliver high quality patient care faster.

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Engage Deeper

Opteamix is a digital automation technology consulting firm with deep expertise in Application Development, Robotic Process Automation, AI, DevOps, Enterprise Mobility, and Test Automation Services. We are headquartered in Denver, Colorado with a wholly-owned delivery center in Bangalore, India.