Revenue Cycle NOW: How Inova and Providence Are Automating the Front End

Revenue cycle executives share how they are deploying self-service tools, robotic process automation, and change management strategies to build a patient-centered and tech-enabled front end.

As health systems face mounting pressure from payer policies and shifting financial responsibilities, the front end of the revenue cycle has become perhaps the most critical control point for preventing downstream denials.

During the recent HealthLeaders Revenue Cycle NOW online summit, the Tech-Enabled Front End session, sponsored by Waystar, explored how health systems are deploying automation strategies to improve the patient experience. The panel featured Mejong Ayeb, Vice President for Revenue Cycle Market Operations at Providence; Rahul Banerjea, AVP of Patient Access and Revenue Cycle Management at Inova; and Christine Fontaine, Growth Enablement Solution Strategist at Waystar.

Here are key takeaways from the discussion.

Relieving Bottlenecks with Self-Service Tools

At Inova, a primary goal of front-end technology is to eliminate bottlenecks and empower patients to manage their own intake. The health system has deployed a mix of virtual registration, e-check-in, and physical kiosks across its ambulatory settings, and it is currently piloting them in emergency and surgical departments.

"Our goal is to never be the bottleneck for any of the work that is done," Banerjea said. "For every self-service tool we implement, we're trying to see incremental change in patient behavior that helps lead us to a decompressed registration state."

By triggering a link for emergency department (ED) self-registration before patients reach triage, Inova is seeing about 60% of eligible patients use the tool. The strategy is not about forcing a singular method on all patients, but rather offering a suite of options to meet varying comfort levels.

Leveraging RPA to Reduce Manual Touches

At Providence, which operates 51 hospitals across seven states, the scale of front-end operations requires robust automation. The health system currently utilizes nearly 500 robotic process automation (RPA) scripts across the front end.

RPA is used to manage tedious workflows, such as automating notification and authorization processes, and then delivering that data directly back into the EHR to eliminate manual data entry, according to Ayeb.

Additionally, Providence is exploring automation to handle state-mandated charity care screenings. Rather than having staff manually process every application, Ayeb envisions a system that automatically identifies presumptive eligibility for patients at or below 138% of the federal poverty level.

"It doesn't need to be a touch every single time," Ayeb explains. "Those are things that can drive efficiency on the front end, looking at areas where technology can actually handle the task, handle the function, and be a definitive as opposed to those more complex cases where you do need somebody to take a look at those."

Navigating Workflow Disruption and Change Management

Implementing new technology on the front lines frequently disrupts established workflows, causing staff frustration and leading to workarounds. Both Ayeb and Banerjea stressed that successful deployment requires rigorous preparation.

Health systems should standardize manual processes before overlaying technology, according to Ayeb.

"If there are variables and we're not quite sure how things are functioning, there's not a standardization across your front end process, and that makes it very difficult to incorporate another vendor or solution into the workflow or even to automate things," she says.

This requires testing and rapid feedback loops, according to Banerjea. He shared an example where Inova rolled out new kiosks in an ED setting but quickly realized the workflow wasn't operating as expected. They paused the kiosks, reverted to manual workflows, and collaborated with their technical team to adjust the solution without forcing staff to struggle through a broken process.

Preparing for Cyber Threats

As health systems expand their digital front doors, the threat of cyberattacks is escalating and becoming a top concern for health systems.

While health systems are accustomed to routine system maintenance, a cyber breach could result in months of downtime. Ayeb emphasized the need to carefully review business continuity plans and coordinate recovery timelines with every vendor.

To prepare for this reality, Inova conducts tabletop exercises with its patient access and HIM teams. These drills are not just planning for a two-day outage, but rather simulating a full 30-day loss of system access to stress-test how the organization would track authorizations, patient information, and clinical safety in a prolonged crisis, according to Banerjea.

The Foundation of a Resilient Revenue Cycle

Ultimately, building a tech-enabled front end requires health systems to view patient access as a strategic financial pillar rather than just an administrative function. By deploying intuitive self-service tools, leveraging RPA to handle complex clearances, and engaging in effective change management, revenue cycle leaders can prevent downstream denials before care is even delivered.

However, as the panel made clear, this technological expansion must be balanced with cybersecurity protocols and realistic business continuity planning. For organizations willing to invest the time in standardizing their workflows and securing frontline staff buy-in, optimizing the front end holds the key to protecting hospital margins while simultaneously delivering a seamless patient experience.