Workflows vs. Automation in Rev Cycle Management

Workflows vs. Automation in Rev Cycle Management

Your organization’s time and money are valuable and should be spent wisely. Many organizations are caught in a web of workflows. Adding more and more, without making progress toward initial goals.

This blog details the differences between workflows and automation and how they fit into the revenue cycle. Understanding what these are and what they do will help you get on track to increase productivity within your organization.

Watch this video to explore the differences between workflows and automation.

Workflows—Why they’re weighing you down

ou may think of workflows in a positive light. And in some instances, they’re a good thing. But in the world of revenue cycle management, they are anything but.

In short, a workflow is like an assembly line for a task. It’s a series of pre-planned (and repeatable) steps that must be taken to complete the task. A checklist, per se. And while it may seem useful, even necessary, workflows weigh your organization down.

In revenue cycle management, there are often many workflows for different tasks, with each staff member or team having narrow functions that they perform repeatedly. Whether it’s for coding, fixing clearinghouse rejections, having multiple different work queues for denials or breaking things apart by payers, workflows are extremely common in revenue cycle management.

Essentially, people are put between systems and practice management systems and clearinghouses aren’t working together the way that they should. People are a necessary go-between for third-party payer portals and payment gateways for individual patients, required to move around data, think about the data they’re looking at, and reconcile data between the systems.

This results in stable productivity that’s measurable and consistent, and it’s been the standard in revenue cycle management for decades.

It does, however, require people for a lot of monotonous, simple tasks, and has downsides including:

  • Waiting for one person to complete a simple task
  • Mistakes in one step leading to mistakes throughout the rest of the process
  • Extra time spent between each step of the workflow

AI automation—How it will save you time and money

Luckily, workflows are no longer a necessary evil. AI automation, especially in revenue cycle management, can mean fewer, more skilled, staff members who are getting more done on a daily basis. Automating tasks that don’t need to be done manually, or with multiple bots or workflows, is a time and money saver.

AI automation means that instead of staff members handling simple tasks, they handle fallout management tasks. A variety of different tasks come into the same queue, such as coding, AR follow-up, reconciliation, appeal, and rejection. There is more variety, meaning the staff members you do hire must be cross-trained. With AI automation, you need to invest more in your smaller staff to train them on these different job functions, but your staff is more well-rounded and can handle lots of different situations.

Instead of the staff becoming experts on the systems, they become knowledgeable about what’s going on with the data. The bots, or brains, as we like to say, are doing the action for them and the staff is simply looking at the results from the automation and comparing that data to fix the resulting fallout.

The result of AI automation is exponential productivity. Because you can add new rules and automation to handle new situations, over time, productivity levels increase per staff member. You can rely on AI automation to do the work for you, rather than hire more people to do the work.

AI automation, essentially, reduces human involvement to the absolute minimum. It allows humans to spend their time on the tasks that require serious thought and (worthwhile) time, and stop wasting it on tedious, but seemingly necessary, ones.

Stop wasting time and staffing on workflows, and start focusing your energy where it counts. AI automation can save you time and money, and the automation you need does exist. AI automation is the future of revenue cycle management, workflows are the past.

Check out this guide today to start having conversations with your team about the benefits of RCM AI!

No Comments

Sorry, the comment form is closed at this time.