End-to-end RCM Automation Services

Eliminate tedious work, improve revenue and give your staff time to provide exceptional care with RPA and Agentic AI services for RCM.

AS FEATURED IN:

Flobotics Forbes 5
UiPath Partner 2

Trusted by U.S. clinics and hospitals to deliver real ROI through Agentic AI automation

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Billion to one
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Automation Agents for Every Stage of the Revenue Cycle Management

Our intelligent Automation Agents automate RCM departments from start to finish, handling everything from eligibility verification and claim management to payment posting and reporting

01

Appointment Scheduling & Patient Registration

Automate patient profile creation in EHR, registration, scheduling / rescheduling appointments and patient communication, such as reminders or follow-ups

02

Benefit and Eligibility Verification

Automate the eligibility verification process in medical billing, reduce wait times and get rid of administrative burdens.

03

Prior Authorization and Verification

Cut through the red tape of prior authorization services with RPA. Accelerate authorizations, minimize denials, and streamline your workflows for better patient and provider experiences.

04

Charge Capture

Automate charge capture workflows, turning complex billing data into into an accurate, swift, and reliable system and achieve financial success.

05

Medical Coding

Automate medical coding processes to achieve unparalleled accuracy and efficiency: reduce errors and save time and empower your coders.

06

Claims Processing

Timely and efficient claims management is one of the biggest challenges for healthcare providers and medical billing companies. Introduce RPA for your claims processing and streamline your operations!

07

Claims Denial Management

Simplify denial processing, reduce errors, and enhance your financial performance.

08

Payment Posting

Transform the way you manage payment posting in medical billing. Simplify and accelerate the payment posting process, ensuring accuracy and speeding up your Revenue Cycle.

09

RCM Reporting

Unlock the full potential of your data with Flobotics’ RCM reporting automation. Experience clarity, efficiency, and precision like never before.

Revenue Cycle Management Automation Services

End-to-end RCM Automation Services

Eliminate tedious work, improve revenue and give your staff time to provide exceptional care with RPA and Agentic AI services for RCM.

AS FEATURED IN:

Flobotics Forbes 5
UiPath Partner 2
Automated claims processing

Trusted by U.S. clinics and hospitals to deliver real ROI through Agentic AI automation

Docplanner
PTCoA
Careviso_grey
Billion to one
Dart Chart_grey (2)
FamilyCare_grey (1)

Automation Agents for Every Stage of the Revenue Cycle Management

Our intelligent Automation Agents automate RCM departments from start to finish, handling everything from eligibility verification and claim management to payment posting and reporting.

Explore possibilites.

01

Appointment Scheduling and Patient Registration

Automate patient profile creation in EHR, registration, scheduling / rescheduling appointments, and patient communication, such as reminders or follow-ups.

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02

Benefit and Eligibility Verification

Automate the eligibility verification process, reduce wait times, and eliminate administrative burdens.

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03

Prior Authorization and Verification

Cut through the red tape of prior authorization. Accelerate authorizations, minimize denials, and streamline your workflows for a better patient and provider experience.

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04

Charge Capture

Automate charge capture workflows, turning complex billing data into an accurate, swift, and reliable system, and achieve financial success.

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05

Medical Coding

Automate medical coding processes to achieve unparalleled accuracy and efficiency: reduce errors, save time, and empower your coders.

Automate Your Medical Coding | RPA for Medical Coding
06

Claims Processing

Timely and efficient claims management is one of the biggest challenges for healthcare providers. Introduce Automation Agents to your claims processing and streamline your operations!

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07

Claims Denial Management

Simplify denial processing, reduce errors, and enhance your financial performance.

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08

Payment Posting

Transform the way you manage payment posting. Simplify and accelerate the process, ensuring accuracy and speeding up your revenue cycle.

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09

RCM Reporting

Unlock the full potential of your data with Flobotics’ RCM reporting automation. Experience clarity, efficiency, and precision like never before.

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RCM Automation Across The Whole  Business Spectrum

EpicCare TherapyNotes SimplePractice Cerner GE Healthcare Praxis eClinicalWorks Nextech Allscripts Athenahealth Nextgen Healthcare Meditech QuestQuanum Collaborate MD Dr Chrono OfficeAlly iClinic Open Dental Nubimed PracticeQ Brightree CentralReach
CareCloud Practice Fusion Practice EHR eHospital Oracle healthcare Cloud Aarogya SoftClinic MEDHOST Sortly InventoryCloud EZOfficeInventory MediTab ScriptSure ZingTree Materialise Vepro Doxy.me OpenEMR Jotform Dexcom
Senseonics Medtronic TriMed Complete Cerner Ambulatory Resideo LifeStream Philips CoachCare Headspace Fitbit Noom Lifesum Acuity Scheduling Hashealth Tebra Power Diary AxisCare LumaHealth DocPlanner Appointy TheraNest Mend Cliniko RXTN IntakeQ
AthenaOne EpicCare TherapyNotes SimplePractice Cerner GE Healthcare Praxis eClinicalWorks Nextech Allscripts Athenahealth Nextgen Healthcare Meditech QuestQuanum Collaborate MD Dr Chrono OfficeAlly iClinic Open Dental Nubimed PracticeQ Brightree CentralReach CareCloud Practice Fusion Practice EHR eHospital Oracle healthcare Cloud Aarogya SoftClinic MEDHOST Sortly InventoryCloudEZOfficeInventory MediTab ScriptSure ZingTree Materialise Vepro Doxy.me OpenEMR Jotform Dexcom Senseonics Medtronic TriMed Complete Cerner Ambulatory Resideo LifeStream Philips CoachCare Headspace Fitbit Noom Lifesum Acuity Scheduling Hashealth Tebra Power Diary AxisCare LumaHealth DocPlanner Appointy TheraNest Mend Cliniko RXTN IntakeQ AthenaOne

Transform Your Business with Revenue Cycle Management Automation

Revenue Cycle Management in healthcare is a perfect playground for implementing process automation. Providers, billing companies and insurers leverage RPA and AI to achieve more while spending less.

Cut operational costs and accelerate cash flow. Get get paid on time, every time and protect your revenue.

Automatically scrubs claims to prevent denials and costly rework. Reduce human errors and focus on high-impact work.

Achieve +95% claims accuracy. Fully automate primary claims, secondary claims and the coordination of benefits.

Automate the whole patient’s journey and give your front desk team all the tools to keep patients informed and taken care of.

Make no room for costly human mistakes and constantly monitor your compliance with HIPAA or other crucial industry regulations.

Connect together all your systems, such as CRMs, EHRs/EMRs, databases, or helpdesk suites, to create one automated productivity machine.

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Recover Revenue Faster

Cut operational costs and accelerate cash flow. Get get paid on time, every time and protect your revenue.

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Eliminate Errors and Prevent Denials

Automatically scrubs claims to prevent denials and costly rework. Reduce human errors and focus on high-impact work.

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Improve Claim Accuracy

Achieve +95% claims accuracy. Fully automate primary claims, secondary claims and the coordination of benefits.

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Provide Excellent Customer Experience

Automate the whole patient’s journey and give your front desk team all the tools to keep patients informed and taken care of.

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Ensure Full Compliance

Make no room for costly human mistakes and constantly monitor your compliance with HIPAA or other crucial industry regulations.

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Achieve True Interoperability

Connect together all your systems, such as CRMs, EHRs/EMRs, databases, or helpdesk suites, to create one automated productivity machine.

Start with RCM Automation

Schedule a free consultation with our revenue cycle automation team.

Let’s overview your RCM workflows and identify the best automation opportunities!

Why Flobotics for Revenue Cycle Management Automation?

Why Flobotics for Revenue Cycle Management Automation?

Deep Understanding of RCM

Over the years, our automation consultants delivered dozens of RCM automation projects and generated hundreds of thousands of dollars in revenue.

100% ROI-Focused

Your Return on Investment is the most important for us. We never take on projects that won’t bring a substantial ROI.

Top Automation Technologies

At Flobotics, we combine the potential of Agentic AI, Robotic Process Automation and Document Understanding to build the most capable Automation Agents.

Full Legal Compliance

Compliance with HIPAA, ACA, HITECH, data security, and governance is at the core of automations.

  • 350%

    Average ROI from a single automation

  • 100+

    Successful implementations

Market-Proven RCM Automation Services

Learn More About RCM Automation

Achieve Fast Outcomes and ROI

Bring Automation Agents to your company.

Revenue Cycle Management Automation – What There Is To Know?

Healthcare is, and should always be, primarily about health. But the inescapable truth is that all medical services cost money.

This obvious fact has led to the development a robust IT infrastructure that manages the healthcare revenue cycle, from handling insurance claims to collecting payments. The whole process is a sequence of numerous tightly interdependent steps. Its complexity leaves room for optimization and very little room for error.

Smooth Revenue Cycle Management (RCM) is critical for adequate healthcare and reducing revenue leakage, but surprisingly few industry leaders perceive its importance. For example, a 2020 report showed that 87% of providers still used manual and paper-based processes for collections. The consequences? 78% claimed they failed to collect payments over $1000 within 30 days. Add fluctuations in healthcare spending, and you have a recipe for an unstable and inefficient system from the perspective of patients and providers alike.

Even though the pandemic has undoubtedly increased the level of digitization in healthcare organizations, many still rely on manual revenue management operations. Luckily, solutions exist that can be quickly adopted and don’t require a massive investment in complex IT infrastructure setup or maintenance. This article will explore some of them, discussing RCM systems for medical services and suggesting how your medical organization can benefit from revenue cycle management automation.

Revenue Cycle Management in the Healthcare Industry

Bring Automation to Revenue Cycle Management!

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Revenue cycle management refers to all the administrative tasks devoted to financial transactions between patients and their providers and how they are handled. The key processes in RCM are:

Pre-authorization — the process starts when a patient makes an appointment. To set up a patient account, the provider must gather and register all the necessary data, such as personal info and medical records, and assess the patient’s insurance eligibility.

Medical coding — next, medical data like test results, diagnoses, or procedures are translated into a unified code. This standardized system facilitates communication between physicians, office staff, insurance companies, and various healthcare providers involved in the treatment.

Claims submission — a coded record of the patient’s treatment is submitted to their insurer, who then reviews and approves or denies the claim.

Payment collection — if the insurer reviews the claim positively, the provider receives reimbursement. The amount depends on the patient’s eligibility, as insurance doesn’t always cover the amount due. If so, the provider must follow up with the patient and collect the rest of the payment.

Service review and reporting — once the payment is complete, the data used in the revenue cycle and clinical treatment is analyzed. This process ensures insight into possible issues and methods of overcoming them to streamline the entire process.

At this stage, it’s important to note that even though the term revenue cycle management is often used interchangeably with medical billing, the two aren’t synonymous.

Revenue Cycle Management in healthcare & medical billing

RCM encompasses all the processes mentioned above, while medical billing refers only to those concerned directly with claims, i.e., coding, submission, and payment collection. In that view, RCM is a broader, end-to-end workflow that includes billing as an important part.

The revenue cycle is affected by many unpredictable, shifting factors that can be internal or external. These moving parts often complicate revenue cycle management, making many cases wholly unique.

External & internal factors that effect revenue Cycle Management

Revenue Cycle Management systems — what are they, and how can they help?

Revenue Cycle Management software aims to digitize and replace paper-based procedures and documentation in the revenue cycle workflows. Think of it as the EHR of medical billing and claim management.

According to a 2021 forecast, the Revenue Cycle Management software industry is expected to grow by 10% annually through 2021 and 2025. This and other research prove that the demand for RCM solutions is rising. And for a good reason.

Revenue Cycle Management systems assist the back-office staff in many essential tasks within the revenue cycle management, such as:

  • claim correction and tracking,
  • KPI reporting,
  • data entry,
  • medical coding,
  • denial management and alerts,
  • contacting patients and insurers,
  • cost estimation.

… and more. They achieve all that by leveraging innovative technologies — including Revenue Cycle Management automation.

Choosing the Right RCM Automation Tool

Many RCM processes — medical billing in particular—can be optimized with the help of intelligent software. What’s more, algorithms can entirely take over the execution of some more straightforward tasks. Here are the most popular solutions used for revenue cycle management automation.

Robotic Process Automation

The name says it all— Robotic Process Automation (RPA) systems use pre-programmed scripts to handle repetitive, rule-based, high-volume tasks.

Many stages in the healthcare revenue cycle are the perfect fit for RPA: scheduling, claims tracking, invoice processing, and most medical billing functions.

You can read more about medical coding automation to know how RPA can help and the RPA development process.

Machine Learning

Machine Learning (ML) algorithms thrive on large amounts of data that hospitals, clinics, doctor’s facilities, and medical research centers can use to boost decision-making capabilities.

In RCM, machine learning can help recognize claims likely to be denied before they are submitted and recommend corrections. Another example is predicting patient outcomes to help providers make informed decisions when handling risk-based cases.

Optical Character Recognition

Optical character recognition (OCR) is a technology that scans documents and images to extract text and convert it into a digital format. OCR programs are commonly used in healthcare to fill prescriptions, medical records, or other documentation quickly.

Faster data entry allows for massive time savings in many RCM-related tasks, such as pre-registration, claims submission, or coding.

Natural Language Processing

Like OCR, natural language processing (NLP) enables faster data extraction. However, rather than scanning the entire text, NLP-based tools focus on identifying key terms in unstructured data, such as doctor’s notes.

Unstructured data is great when dealing with complex, unique cases, but it usually takes longer. Capable of capturing more sophisticated texts, NLP allows medical staff to communicate naturally without compromising billing and coding efficiency.

Intelligent Automation

Last but not least, intelligent automation (IA) is the ultimate combination of other automation solutions. They are deployed as a single high-synergy system that is efficient, smart, self-learning, and can deal with any data.

When used in RCM, IA combines the best of all worlds. For example, AI can go through patient data extracted and formatted by OCR/NLP in search of repeating patterns. The AI then identifies standard procedures that can be delegated to efficient, pre-programmed RPA bots.

The benefits of RPA in Revenue Cycle Management

While the above solutions find use in Revenue Cycle Management automation, they vary in deployment complexity and day-to-day operations. RPA usually requires the least effort and investment of all five while promising relatively fast ROI.

That’s not to say that RPA implementation is straightforward. On the contrary, a recent survey by Becker’s Hospital Review reveals that although 51% of providers incorporate some form of RPA in their systems, just 7% would classify the adoption as “mature” and 33% as “robust.”

Still, when you are supported by a trusted team of automation experts, deploying the Robotic Process Automation Revenue Cycle is a significant first step toward further automating your financial operations. That’s because Revenue Cycle Management, by its nature, is:

1. Repetitive — sending invoices, receipts, payment reminders, verifying patient data, and checking regulation compliance — are some tedious daily billing operations that RPA bots excel at.

2. Rule-based — as a whole, the revenue cycle is complex but consists of numerous simpler steps. Many of these stages can be managed by bots, allowing your staff to focus on other, more demanding tasks.

3. Prone to error — since scripts don’t get tired and don’t lose focus, they’re less likely to make typos or leave form fields unfilled. They can assist human billers in complicated cases, suggesting corrections and insights.

4. Costly — MGMA estimates that in 2020, the US healthcare industry lost over $16 billion due to revenue cycle inefficiencies. Many of them could have been resolved with automated revenue cycle management.

How to use RPA in Revenue Cycle Management?

Using RPA opens up new opportunities to optimize the processes within the revenue cycle. Here are some of them:

Faster cost estimates — automating the benefits retrieval process will expedite cost estimate turnover.

Pre-authorization assistance — RPA bots pull patient data from other systems and upload them directly into your Hospital Information System (HIS), reducing delays.

Enhanced patient communication — RPA will automatically schedule meetings and send patients reminders or recaps of the information shared on a phone call.

Automated data entry — RPA can integrate the data from various sources into your system faster and more precisely, preventing simple errors and resulting denials.

Compliance — by reducing manual processes, RPA helps providers avoid errors and assure compliance with HIPAA and other regulations.

Handling orders and referrals — manually reviewing referrals and orders creates further delays in the revenue cycle. In contrast, RPA handles order scheduling and confirmation, enabling a smoother RCM.

Claim denials management — simple cases of claim denials can be handled entirely by RPA bots while your staff works on the more complicated ones.

Third-party integrations — efficient RCM often requires multiple tools from different providers. RPA ensures that all of them work together seamlessly.

Improved patient experience — RPA revenue cycle ensures faster claim processing, improved communication, and higher efficiency, encouraging patients to choose you over other healthcare providers.

Conclusion

With constant regulation changes, cost fluctuations, and unforeseeable challenges like COVID-19, delivering high-quality medical services isn’t possible without a stable financial infrastructure. For this reason, healthcare leaders are adopting automated solutions that allow for efficient and secure revenue cycle management.

Suppose you’re looking for a trusted partner to automate your organization’s RCM systems; contact us at Flobotics. We have vast experience working with medical companies and believe in the ROI-first approach — we always consider the costs and potential gains to help our clients save and earn as much as possible.

Are there specific challenges to consider when integrating RCM automation in healthcare?2024-02-28T20:11:36+01:00

Integrating RCM automation in healthcare can pose some challenges like ensuring seamless integration with existing systems, managing data privacy and security concerns, overcoming resistance to change among staff, and aligning automation processes with complex regulatory requirements in the healthcare industry. Healthcare providers may also face challenges related to the initial investment costs, selecting the right automation tools, and adapting workflows to optimize the benefits of RCM automation effectively.

What is the RCM automation approach?2024-02-28T20:06:29+01:00

The RCM automation approach involves leveraging advanced technologies like RPA to optimize and streamline tasks within the healthcare revenue cycle. RPA plays a vital role in automating repetitive and rule-based processes such as claims processing, eligibility verification, and payment posting, leading to increased efficiency and reduced manual errors. By integrating RPA into the RCM automation approach, healthcare organizations can achieve enhanced accuracy, faster processing times, improved revenue capture, and better compliance with industry regulations, ultimately transforming their revenue cycle operations for greater effectiveness.

How can healthcare RCM automation systems improve compliance2024-02-28T20:00:57+01:00

Healthcare RCM automation systems can enhance compliance by ensuring accurate and consistent adherence to billing regulations, coding standards, and healthcare policies. Through automation, these systems validate coding accuracy, streamline claims processing, and reduce human errors, thus minimizing compliance risks. Additionally, automation software can maintain audit trails, track changes, and generate detailed reports for transparency and regulatory compliance monitoring. By automating repetitive tasks and enforcing standardized processes, healthcare RCM automation systems help organizations maintain compliance with industry regulations and improve overall operational efficiency.

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