Automation has become commonplace in the revenue cycle, and as leaders look to remedy staffing issues, adding technology may be more important than ever.
Technology has started to play an even bigger role in the revenue cycle as staffing shortages seem to have hit a high.
To this point, more than 57% of health systems and hospitals have more than 100 open roles to fill, with one in four finance leaders needing to hire more than 20-plus employees to fully staff their revenue cycle departments, according to a recent survey.
Automation has been a clear solution to not only alleviating staffing issues in revenue cycle but making the administrative process more efficient overall. While, according to survey, the use of automation in revenue cycle operations increased in 2021 from 66% to 78%, there remains a demand for further implementation to relieve the burden on staff.
In fact, one recent revenue cycle leader HealthLeaders spoke to about its automation journey was Jamie Davis, executive director of revenue cycle management at Banner Health. Banner's journey in implementing the use of AI and automating its revenue cycle management wasn't an easy process, but it was necessary to protect the organization against revenue leakage.
Banner Health currently has 22 day-to-day bots helping with its revenue cycle management. These bots complete tasks like adding insurance information and updating medical records. "All the things that our human resources shouldn't waste their time doing," Davis said.
These bots manage roughly 90 million records for Banner Health, and from mid-2020 to 2021, Banner has saved about 1.73 million man-hours by deploying them, Davis explained. Banner Health also has machine learning in its refund and variance space to help with credit and debt balances.
When it comes to taking on such a large automation endeavor, partnerships are needed Davis says.
"Our automation is done completely in partnership with our IT group. They have their own robotic process automation center of excellence, but they've also started dabbling in some process mining in our health plan data. And we are working towards automating things like low balance accounts receivable management and denials," Davis says.
"The automation of the denials, low balance accounts receivable management, and the variances is really fun and innovative. That's where it's really rolling into that intelligent automation space since it's using machine learning that is predicting and reacting," Davis says.
So what can other revenue cycle leaders do when looking to streamline, or even implement, technology at their organizations?
To shed some light, Brenda L. Erley, CDEO, CPC, CCS-P, CPB, director of front and middle revenue cycle management services, at Strivant Health, recently spoke to Healthleaders on how revenue cycle leaders can better streamline technology, alleviate staffing issues, gain administrative buy-in, and see a ROI.
Healthleaders: Where are organizations seeing the biggest gaps right now and how can technology help improve them?
Brenda Erley: Due to staffing shortages, the need for assistance with coding denials and follow-up is probably the biggest gap we are seeing. When the technology is there to code accurately at initial claim review and submission, then the expectation would be a reduction in the need for coding denials and follow-up.
HL: What tips do you have for revenue cycle leaders looking to streamline their revenue cycle management?
Erley: Investing in AI and bots to assist wherever an organization can is paramount to streamlining an organization's revenue cycle management operations. This can help to alleviate the repetitive day-to-day tasks so team members can focus their energy and attention on more crucial revenue cycle operations. This can be anything from daily reporting to eligibility, charge entry, and coding.
HL: Revenue cycle leaders are faced with ample workforce challenges right now including both hiring and maintaining staff. How can technology help remedy this?
Erley: Technology doesn't get sick, it doesn’t take days off, it doesn't have to play catch up, it doesn't have bad days or good days. It is just there constantly working and processing consistently. Downtime is minimal, if non-existent, for technology, and this overall consistency helps to avoid those peaks and valleys we see in charges and reimbursement when there are disruptions in staffing.
HL: How can revenue cycle leaders position themselves best for administrative buy-in when looking to implement new technology?
Erley: Research the technology, and put the time into building, testing, and auditing. If you can, revenue cycle leaders should also have provider buy-in so they can be an advocate for documentation improvements within their organization to further enhance the success of technology. The time you put in at the beginning will reap greater results in the end. Technology is all about adoption. Without adoption from everyone including the physicians, administrators, and c-suite executives, organizations generally won’t see the ROI.
“Investing in AI and bots to assist wherever an organization can is paramount to streamlining an organization's revenue cycle management operations. This can help to alleviate the repetitive day-to-day tasks so team members can focus their energy and attention on more crucial revenue cycle operations.”
Brenda L. Erley, CDEO, CPC, CCS-P, CPB, director of front and middle revenue cycle management services, at Strivant Health
Amanda Norris is the Associate Content Manager of Finance, Payer, Revenue Cycle, and Strategy for HealthLeaders.