5 ways RPA is transforming medical claims processing

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    Healthcare providers are actively looking to deliver better care and their strategies to accomplish this mainly include cloud technology and process automation

    Process automation has a myriad of benefits, and one of the top ones includes medical claims processing. While medical claims processing is tedious and time-consuming; it also directly impacts any business’ financial health. 

    Drawbacks of processing medical claims manually

    Medical claims processing requires following a host of steps, all of which are necessary whenever a patient visits any healthcare provider: 

    • Data extraction — the provider collects the patient’s insurance data
    • Verification — the provider confirms eligibility and related benefits
    • Submission — the provider submits an accurate claim

    This iterative process is complicated for the following reasons-

    1. Insurer systems vary from provider to provider
    2. Errors are inevitable and costly
    3. Providers submit a high volume of claims
    4. Cash flow hinges on timely, accurate claims 

    5 key benefits of automation in claims processing

    Fortunately, automated claims processing is addressing these challenges head-on, and RPA (Robot Process Automation) is the ideal solution for medical claims processing,

    Rule-based RPA bots are configured to extract patient insurance information, format claims submissions appropriately, and then submit it. The result is a faster, more accurate process that frees up valuable human resources, allows healthcare providers to expand, and offers a continual return on investment. 

    Here’s how automation improves medical claims processing:  

    1. Faster claims processing:

    RPA bots enable processing higher volumes of data faster than the human workforce. Bots also work round the clock with the same amount of accuracy and clarity. 

    Programming and deploying even a single bot to handle claims helps healthcare providers determine how many claims one bot can turn around within a day. The providers then add additional bots (each doubling the initial bot’s output) until the target number of claims is processed every 24 hours. 

    Suggested Read- Benefits of RPA in the Pharmaceutical industry

    2. Minimized errors:

    Automation leaves no room for any kind of errors: invalid medical codes, wrongly entered patient insurance data, and non-compliant submission formats to start.

    RPA bots for claims process automation alleviate human error by:

    (1) Performing consistently (every task is executed with the exact same level of accuracy, from first to last). 

    (2) Validating process (an RPA bot doesn't perform any task outside established parameters).

    (3) Conserving human attention and focus for higher-level work (mitigating human error due to lack of attention or fatigue). 


    3. Job satisfaction:

    Human beings are capable of bringing about innovation, insights, empathy, and creativity. Employing humans to copy-paste data between systems for hours on end isn’t the best use of their time or ability, especially with most healthcare providers focused on providing better patient care by improving healthcare and lowering costs.

    By automating claims processing, a task executed to perfection by RPA, clinics, and providers dedicate human resources to furthering their mission, while increasing employee satisfaction and productivity. 

    4. Need-based scaling:

    Manual tasks like claims processing consume a chunk of key staff members’ time. Automating claims processing helps organizations keep up with the rapid growth and gain a competitive edge. Freeing up team members to focus on value-added responsibilities helps businesses meet increasing demand and attract a large number of patients. By implementing RPA bots, the provider can process a nearly unlimited number of claims. 

    5. Substantial and sustained ROI: 

    Faster and more accurate claims processing enables prompt and consistent payments, without any need to rectify errors or push through a backlog. Increased human productivity yields higher returns and increased retention rate, and the potential to scale because automation in claims processing enables higher claim volumes, which helps companies gain substantial ROI.

    Secondly, RPA tenders lasting value. Once a bot is programmed, it works for the long haul, as compared to each new human employee who requires onboarding to learn the ins and outs of all complicated processes. 


    If you’re looking forward to automating claims processing, there’s an added benefit of RPA to consider. RPA pairs best with Hyperautomation to streamline business processes and facilitate end-to-end intelligent automation. 

    Deploying RPA is well worth the returns, especially when a reputed RPA solutions provider like Neebal can provide you unlimited license free bots, helping you save expenses on recurring bot license renewals. Our team of experienced technology experts enables fast solution development and implementation. Would you like to reap the benefits of automation too? We’re here to help! Schedule a call today with one of our top experts to get started! 

    Topics: RPA Solutions, Hyperautomation