Author: Daniel Vachoo, Director, Customer Success

 

Like most Americans who are sheltering at home during the ongoing coronavirus pandemic, I’ve been spending more of my life online. It’s no surprise that video streaming services such as Netflix have seen a 16% increase in their daily average users in recent months. Personally, I’ve found myself binge-watching more episodes of ‘The  Office’ in the last 6 months than ever before. I’ve tried to draw inspiration from my compulsive TV viewing to make more sense of the world around me.

A surprising end result of this compulsive TV viewing is that “The Office” has provided insight into the most unexpected area: healthcare.

“The Office,” Costly Healthcare Administration, and Automation

In Season 1, Episode 3 of ‘The Office’ titled Health Care, Office Manager, Michael Scott (Steve Carell) leaves subordinate, Dwight Schrute (Rainn Wilson) in charge of selecting a new healthcare plan for the paper company staff of Dunder Mifflin. No spoilers, but it ends disastrously. Humor aside, this episode, highlights 3 important facts about the US healthcare system:

At AKASA we believe every dollar spent on healthcare matters because healthcare matters to everyone. We believe complexity in medical billing and reimbursement in the United States drives up hidden costs that we all pay, both in terms of dollars and in the erosion of trust people have that our healthcare system will serve them well.

For instance, the Claim Status function in healthcare revenue cycle operations entails complete follow-up to claims filed by the health system or provider that have not received a response from payers or insurance companies. This is done by checking the status of each individual claim on payer websites, pulling back relevant information into electronic health record (EHR) or Patient Accounting Systems (PAS), and prioritizing the need for escalation with the payer. This process is largely a manual exercise at most healthcare organizations today.

As an industry average, each manual claim status inquiry takes 9 minutes of provider staff time which translates to an annual potential savings opportunity of $3.6 billion for our healthcare industry. With the backdrop of a global pandemic, thinning hospital margins,  V-shaped recovery of hospital claim volumes, and an ever-changing set of payer rules, this is simply not the best use of our hospital resources, period. The revenue cycle is ripe for automation and we need to empower our peers in these functions to work on the top of their license with a core focus on patient experience.

The current manual claim status efforts have netted in subpar results with providers always playing catchup with their outstanding claims. A/R has piled up while cash flow streams have stayed stagnant. But, there’s hope.

Streamlining the Revenue Cycle with Unified Automation™

At AKASA, we’ve helped several organizations tackle administrative time sinks across the revenue cycle leveraging the true power of Unified Automation™. Unified Automation™ observes actions, learns them, and performs them faster and more accurately than is possible through manual processes. We start by deploying proprietary software that captures multi-modal data to get a 360-degree view of current workflows and processes. Our team then discretizes this data to train our machine learning algorithm. Our algorithms then automatically construct complex flows that would be impossible to script by hand. Our model also identifies broken workflows, corrects them, and learns from them, often eliminating unnecessary work. Finally, our AI then gets to work performing claim status checks 24/7.

Unified Automation™ is particularly well suited to healthcare revenue cycle management functions such as claims status because it is antifragile, which extends beyond simple resilience or robustness and creates a system that actually improves in response to variance and constantly changing variables – a critical capability for any automation system in the revenue cycle.

Antifragile and Unified Automation are not just  “buzzwords,” they actually elevate the revenue cycle automation to a whole new level.  If a Health System upgrades its EMR, there is no impact on the automation output. If a payer website goes through a drastic facelift, there is no need to spend hours re-writing RPA bot rules. We don’t just put things in a queue for a human to review and tell us what to do next, we complete the full workflow by specifying the exact next action.

Case in point, at a large health system in the midwest, in less than 6 months, our Unified Automation™ solution has contributed to the equivalent of 15-17 full-time employees checking claim statuses 24/7.  This has saved the organization 6,000+ staff-hours to date, allowing them to refocus their staff on true revenue-generating activities.

Dwight Schrute’s dilemma to choose between the health of his colleagues vs. profit margins of his employer is not unique to Dunder Mifflin—it’s a story we see playing out across the country. We wholeheartedly believe that automation across the entire revenue cycle process can help healthcare organizations save millions of dollars in recovered revenue annually which will ultimately result in a lower cost of care for everyone.

Form-Logo

Sign up for our Newsletter

You May Also Like

Blog Resource
Apr 5, 2022

5 Takeaways from HIMSS' Panel on Automation and the Patient Financial Experience

Last week, HIMSS Global Health Conference and Exhibition, the annual premier event that brings together thousands of healthcare industry leaders...

Blog Resource
Apr 5, 2022

Top 5 Benefits of Revenue Cycle Management in Healthcare

How automation empowers efficient revenue cycle management Why is the revenue cycle management process important in healthcare? In short,...

Blog current-challenges
Mar 29, 2022

Current Challenges and Best Practices for Hospital Revenue Cycle Management

  Hospital revenue cycle management (RCM) is a fundamental pillar of how every hospital operates. RCM consists of interdependent...

Blog Resource
Mar 16, 2022

Unpaid Claims? Poor Patient Experience Might Be To Blame

  Hospitals and health systems in the U.S. have been hyper-focused on improving the patient experience in recent years...

Blog Resource
Feb 19, 2022

There Is Hope: 5 Takeaways from the Great Resignation and the Added Impact on Healthcare Revenue Cycle

  The Great Resignation has significantly affected all industries in the U.S., but suffice to say, healthcare has been...

Blog Resource
Feb 8, 2022

29 of the Best AI and Automation Quotes to Inspire Healthcare Leaders

Automation technologies, including artificial intelligence (AI), are not novel ideas by any means, but they have garnered a lot...

Blog Resource
Jan 31, 2022

9 Things to Look for When Selecting an RCM Automation Provider

RCM automation efforts have been in use for some time now, though with varying abilities and to varying degrees....

Blog Resource
Jan 18, 2022

4 Ways to Level-Up Your Revenue Cycle Management Automation

Revenue cycle management (RCM) automation has become a top priority for providers. With the decline in patient volumes and...

Find out how AKASA's AI-driven automation can help you.