Prebilling Efficiency: Welcoming Automation into Your World

By Ted Williams, Partner, Payor Logic
Twitter: @PayorLogic

It Starts with a Problem
Efficiency often evolves from problems. There are examples of problems transformed into efficiency everywhere we turn. The advent of the Keurig K-Cup reduced the steps required for your favorite cup of java to the push of a button. Amazon’s patented 1-Click ordering is so easy that my brother accidentally bought a television. Twice. In the same day! The 1-Click revolutionized the online shopping experience, reducing the industry’s average shopping cart abandonment rate of 70 percent (better for Amazon) and streamlining the shopping experience (better for the shopper).

The first rule of any technology used in a business is that automation applied to an efficient operation will magnify the efficiency. The second is that automation applied to an inefficient operation will magnify the inefficiency.
-Bill Gates

We once had a customer explain to us their existing insurance discovery processes that involved a combination of documenting, printing, scanning and entering the same information multiple times through the revenue cycle. The only apparent reason for the duplication of steps was: That’s the way it has always been done. Inefficiency was magnified in this case and our mission was to fix the problem. Maybe you’ve seen this before. Maybe you’ve experienced it yourself. In the revenue cycle, automation is paramount. Here are six automation benefits for healthcare billing offices:

  1. Efficiency. Most healthcare prebilling operations include several repeatable actions. For instance, demographic verification is very common. Checking insurance eligibility is almost a given. Efficiency is achieved when these and related tasks can be combined and reduced to the click of a button. This efficiency is multiplied in more complex situations such as ineligible payor responses or charity application processes—the components of which can be automated.
  2. Consistency. Tracking adherence to some practices in a billing office is nearly impossible, creating tension among employees and headaches for management. Consistent processes are achievable through automation, creating a lasting impact downstream. Compliance can be documented in great detail with automated reporting mechanisms.
  3. Scalability. Some platforms offer click-and-drag edits, providing a nimble organization poised for growth with the flexibility to navigate turbulent waters with grace. This level of automation is far easier than retraining employees on when and how to insert new procedures. For example, if an organization wants to experiment with the best place in the workflow for verification of demographic information, an efficiently automated environment can make these changes in minutes and apply them throughout the organization.
  4. Quality. Can quality actually improve as efficiency increases? Absolutely. When automation is done correctly, outcomes are enhanced, and measurable results paint a clearer picture compared to manual efforts. Improved accuracy is a sure bet when removing unnecessary human intervention from the equation. The results include reduced denials, less returned mail and a lower self-pay population when using advanced automated solutions such as Insurance Discovery.
  5. Analytics. Automated environments are fertile soil for advanced analytics and reporting metrics. When tweaks are made to a process, performance can be measured against real baselines, proving value and ensuring a return on investment. Regular reports containing information from key performance indicators (KPIs) can assist in tracking progress for months and years ahead.
  6. Affordability. The ability to accurately predict technology or data expenses can be helpful in adhering to budgetary requirements. A holistic view of cost-benefit analysis often proves that implementing technology is much less expensive than existing processes. Here’s how one Payor Logic client puts it: “When you track and review Payor Logic’s return on investment, the value is clear—and that’s not just for hard costs. It’s for soft costs too, including the amount of staff time saved.”

Automation can be hard to justify, especially when old processes have been in place for many years. Here is how an EMS billing agency turned an old-school process on its head and saw ROI in just 90 days.

This article was originally published on Payor Logic and is republished here with permission.