Intelligent automation — a tool leveraged across industries to accelerate and standardize workflows, solve staffing problems and elevate the user experience — has finally arrived in healthcare.
Amid an intricate and fragmented health insurance landscape, one of its most significant contributions lies in helping improve patient access and the patient experience.
During an April webinar hosted by Becker's Hospital Review and sponsored by Notable Health, Notable's head of patient access solutions, Bri Buch, and head of revenue cycle solutions, David Sugitpibul, discussed patient access challenges many organizations face and how intelligent automation can help solve those challenges.
Three insights:
1.) The top patient access challenges are payer mix changes, claim denials and bad debt. In 2021, the number of Medicaid and self-pay/uninsured patients rose by 34 and 22 percent, respectively, while commercially insured patients decreased by 29 percent. The rate of insurance claim denials increased by 33 percent and bad debt grew by 27 percent, according to research cited by presenters. Revenue cycle management teams also found themselves dealing with increased employee turnover and staff shortages. These trends all impact revenues.
In the face of such challenges, common approaches for revenue cycle improvement, such as outsourcing and acquiring point solutions, are inadequate. "The reason that neither outsourcing nor point solutions can fix our revenue cycle is that they don't disentangle the massive web of largely manual interactions," Mr. Sugitpibul said, referring to the laborious RCM process of completing paper forms, entering and reconciling repetitive data, attending calls, sending and receiving faxes and managing work queues.
2.) Intelligent automation solutions streamline workflows and reduce fragmentation. The main mechanism for achieving this is digitizing and automating manual RCM workflows by leveraging digital assistants. Notable takes a strategic approach to doing so by:
- Codifying how optimal workflows should work and baselining from there.
- Standardizing workflows for maximum efficiency and impact, based on patient preferences and behaviors on the one hand, and payer or policy changes on the other.
- Automating and digitizing RCM processes using digital assistants to increase speed, improve quality and expand capacity for teams.
To make this transformation happen, Notable deploys five key capabilities:
- Intelligence to determine when and how to perform a workflow on behalf of physicians.
- Personalized engagement to prompt the appropriate parties to take the next step.
- Seamless integration to link disparate systems and interfaces via application programming interfaces and robotic process automation.
- Self-serve configuration to enable no-code optimization of automation to meet the unique needs of each organization.
- Root cause analytics to drive continuous improvement and staff adoption.
3.) Future-forward organizations are already using intelligent automation. A multi-specialty clinic in the Southwest U.S. was aware of the need to improve the experience for patients who were dissatisfied with its call center. The organization also wanted to lower the administrative burden associated with patient registration and to reduce claim denials, many of which were linked to inaccurate registration data, according to the presenters.
Through its partnership with Notable, the clinic addressed these challenges by automating a series of previously manual patient access workflows. These workflows included appointment reminders, new and existing patient pre-visit registration, insurance card capture, plan selection, eligibility verification and consent forms. "The downstream effect of this was minimizing outbound calls that could have been necessary to successfully get patients to complete the registration process," Ms. Buch said. "Seventy-eight percent of these registrations are completely touchless, which also minimizes work queue volume for front desk and call center staff."
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