Automating Benefit and Eligibility Verification

Prior Authorization and Verification Automation Services

Empower your RCM with Flobotics’ prior authorization automation—because every second counts in patient care.

A PROVEN HEALTHCARE AUTOMATION PARTNER:

Prior Authorization and Verification Automation Services

Empower your RCM with Flobotics’ prior authorization automation—because every second counts in patient care.

Prior authorization and verification automation services

A PROVEN HEALTHCARE AUTOMATION PARTNER:

Redefine Efficiency in RCM with Automated Prior Authorization

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

03.  Prior Authorization and Verification

Eligibility Verification

RPA bots can swiftly verify coverage by interfacing with payer portals and EHR systems, documenting eligibility for procedures or medications.

Document Submission

Automating the compilation and submission of necessary patient information and clinical documents to insurers streamlines the authorization process.

Status Monitoring

Bots can routinely check the status of authorizations and notify staff of pending actions or the need for additional information.

Record Updating

Upon authorization decision, RPA updates patient records with pertinent details, ensuring readiness for treatment and billing.

Eligibility Verification

RPA bots can swiftly verify coverage by interfacing with payer portals and EHR systems, documenting eligibility for procedures or medications.

Document Submission

Automating the compilation and submission of necessary patient information and clinical documents to insurers streamlines the authorization process.

Status Monitoring

Bots can routinely check the status of authorizations and notify staff of pending actions or the need for additional information.

Record Updating

Upon authorization decision, RPA updates patient records with pertinent details, ensuring readiness for treatment and billing.

HOW DOES IT WORK IN PRACTICE? [PTCOA CASE STUDY]

Automating Claims Submission

Pain Treatment Centers of America (PTCoA) is Arkansas’s largest fully comprehensive pain management practice network.

We built over 10 RPA bots that automated various PTCoA processes. We automated the retrieval of historical patient data & their analysis.

Watch the RPA bot automatically submitting claims in PrognoCIS EHR system.

449%

ROI in one year

6FTEs

monthly saved

10 bots

built so far

+$400K

saved in year one

Why RPA for Automated Prior Authorization in the RCM?

Fast-track authorization processes from days to hours.

Slash operational costs with automated, paperless systems.

Experience fewer denials and improved cash flow with efficient prior authorization services.

Deliver timely healthcare services with expedited authorization approvals.

Speed up your whole Revenue Cycle Management!

We help healthcare providers building automated patient management workflows

Schedule a free consulting session and see the live demo of your potential use case.

Photo of Filip Nasiadko - CEO of Flobotics

We have streamlined processes for

Quick Approvals

Fast-track authorization processes from days to hours.

Cost Savings

Slash operational costs with automated, paperless systems.

Revenue Boost

Experience fewer denials and improved cash flow with efficient prior authorization services.

Enhanced Patients Satisfaction

Deliver timely healthcare services with expedited authorization approvals.

Faster Revenue Cycle

Speed up your whole Revenue Cycle Management!

Building Automated Patient Management Workflows

Schedule a free consulting session and see the live demo of your potential use case.

Photo of Filip Nasiadko - CEO of Flobotics

We have streamlined processes for

What are the tasks of prior authorization?2024-01-29T20:46:45+01:00

Prior authorization tasks in RCM involve submitting requests, verifying eligibility, evaluating medical necessity, documenting and communicating information, and receiving approval or denial decisions. By automating these tasks, healthcare providers can streamline the process, reduce manual effort, improve accuracy, and expedite approvals. Automation technology facilitates seamless communication between providers and insurance companies, ensuring efficient exchange of information and adherence to insurance guidelines.

What is electronic prior authorization?2024-01-29T20:45:32+01:00

Electronic prior authorization (ePA) is a digital process that automates and streamlines the prior authorization workflow in healthcare. It replaces traditional manual methods by electronically exchanging information between healthcare providers and insurance companies. ePA enables real-time submission, review, and approval of authorization requests, reducing paperwork, delays, and administrative burden. This digital system improves efficiency, accelerates the authorization process, reduces errors, and enhances overall RCM by ensuring timely access to necessary medical treatments and services.

What are the benefits of automating prior authorization?2024-01-29T20:44:36+01:00

Automating prior authorization in healthcare RCM processes improves operational efficiency by streamlining the authorization workflow, reducing manual tasks, and accelerating the approval process. Automated systems ensure accuracy and compliance by consistently applying payer guidelines and medical necessity criteria. This reduces errors, minimizes denials, and enhances revenue cycle performance. Additionally, automation reduces administrative costs, enhances resource utilization, and improves patient experience by expediting access to necessary medical services.

Streamlining Prior Authorization and Verification with RPA: Enhancing Healthcare Revenue Cycle Management

Efficient management of revenue cycle processes is crucial for healthcare organizations to optimize their financial operations. The Prior Authorization and Verification stage plays a significant role in these processes. Explore how Robotic Process Automation (RPA) can bring efficiency and accuracy to healthcare organizations by automating these critical workflows.
Understanding prior authorization and verification ensures that healthcare providers receive approval from insurance payers before performing specific medical procedures or treatments. Verification involves confirming patient insurance coverage and eligibility before providing services.

What Are the Automated Workflows for Prior Authorization and Verification?

  1. Automated Eligibility Verification
    RPA retrieves patient information from multiple sources, such as electronic health records (EHRs) and insurance portals, to verify insurance coverage and patient eligibility. This automation streamlines the process, reduces manual effort, and minimizes errors.
  2. Automated Prior Authorization Requests
    RPA generates and electronically submits prior authorization requests. Bots collect patient and procedure details, populate forms accurately, and forward them to the appropriate insurance payer. This eliminates manual paperwork, expedites the process, and reduces potential errors.
  3. Automated Follow-up Communications
    RPA bots track and follow up on prior authorization requests. They communicate with insurance payers, confirm request receipt, and monitor approval status. Automating these follow-up tasks minimizes delays, expedites patient care, and ensures timely approvals.

Benefits of RPA Automation for Prior Authorization and Verification

  • Enhanced Efficiency and Reduced Manual Effort: RPA eliminates manual data entry, form filling, and repetitive prior authorization and verification tasks. This frees up staff to focus on higher-value activities, improving overall efficiency.
  • Improved Accuracy and Compliance: RPA automates the validation of prior authorization requirements, ensuring adherence to payer guidelines and protocols. This reduces errors, improves compliance, and minimizes denials or reimbursement delays.
  • Faster Turnaround Times: RPA expedites prior authorization and verification processes. Bots retrieve and analyze data swiftly, submit requests promptly, and monitor progress continuously. Streamlining these workflows leads to faster approvals, reduced patient wait times, and timely initiation of treatments.

Why RPA for Prior Authorization and Verification Automation?

Reduced Costs and Increased Revenue:

RPA automation reduces administrative costs associated with manual processes. By eliminating the need for additional staff and minimizing errors, healthcare organizations can achieve cost savings and improved reimbursement rates.

Enhanced Patient Satisfaction:

Automation simplifies the prior authorization process, reducing wait times and providing a smoother patient experience. Faster access to necessary treatments boosts patient satisfaction with healthcare providers.

Scalability and Flexibility:

RPA allows healthcare organizations to scale prior authorization and verification processes seamlessly. Bots handle higher workloads without compromising accuracy or efficiency, accommodating increasing volumes.

Final thoughts

RPA significantly benefits revenue cycle management’s Prior Authorization and Verification stage. Automating workflows, RPA enhances efficiency, reduces manual effort, and improves accuracy and compliance. With reduced costs, faster turnaround times, and enhanced patient satisfaction, RPA offers healthcare organizations a valuable tool to streamline their revenue cycle management and optimize their financial health. Embracing prior authorization automation services through RPA enables healthcare providers to focus on delivering high-quality patient care while achieving greater operational efficiency.

Automate boring sh*t in healthcare!

Read the RPA whitepaper for the medical & healthcare industry.

Transform Your Prior Authorisation Workflows with RPA

Contact us to explore the benefits of RPA in streamlining your patient management workflows.

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