A smooth patient journey requires efforts from a lot of players in the healthcare ecosystem. The point-to-point ecosystem of today has become stagnant and is not helping the increase of efficiency.
An interconnected and automated back office can help both payers and providers.
How disconnected are Healthcare Systems today?
- EHR portals: Most EHR portals are disconnected in one way or another. One of the most common ways is through the use of firewalls. these firewalls can block certain ports that are needed to communicate with the EHR portal. Other disconnect methods include the use of proxies and authentication servers.
- Clearing houses: Clearing houses are creating a two-tiered system in which only wealthy patients can afford to receive care. Clearing houses are also making it difficult for hospitals to negotiate prices with insurers, which is driving up costs. As a result, hospitals are losing money and valuable time.
- Multiple providers and payers: The healthcare ecosystem is becoming more complex as multiple providers and payers enter the market. This can be challenging for patients who need to navigate through the various systems to get the care they need. It can also be difficult for providers and payers to coordinate care and ensure that patients receive the most appropriate treatment.
- Eligibility and cover systems: One of the main issues that providers are facing is the changes in eligibility and cover systems. These changes are affecting how providers are paid, and sometimes they are not getting paid at all for services provided. This can be very difficult for providers who are trying to maintain their businesses.
- Old technologies: Older technologies like fax and mail are still prevalent in many organizations. These often slow down processes and can create bottlenecks in provider systems. Even the use of mainframe computers are a hindrance to smooth workflow. These systems need constant upgrades and maintenance.
How Providers and Payers can collaborate to create a Seamless Data Highway?
- Automating the revenue cycle: Automation can help with tasks such as claim submission, eligibility checking, and payment processing. This can help to reduce administrative costs and improve efficiency. As humans, we are prone to errors so automation can also help to ensure that patients receive the correct reimbursement amounts for the services every time.
- FWA analytics: Healthcare payers can use FWA analytics to help identify improper payments and patterns which can help predict FWA claims. An automated FWA analytics system can identify patterns in billing and utilize that to indicate errors in real time. This will ultimately help prevent unnecessary overheads cost from FWA claims.
- Cost transparency: Cost transparency has three-sided benefits. First, payers can use cost transparency to negotiate better rates with providers. Second, providers can use cost transparency to identify areas where they can improve efficiency and reduce costs. Finally, patients can use cost transparency to make more informed decisions about their healthcare coverage and care.
- Automate with integrated EHRs and payment portals: Healthcare providers can take advantage of integrated EHRs and payment portals to improve their workflow and accuracy of billing. Integrated EHRs can help to improve the quality and accuracy of patient information, and can also provide effective communication among providers. When an integrated EHR is hooked up with an automated payment portal it same valuable time and frees providers from the mundane work of data entry. It can easily pull all the necessary information required during the payment process from the EHR.
Conclusion
With more than ten years of experience in the creation of healthcare software, we at Nalashaa advise taking a cautious but gradual approach when using RPA in your healthcare practice. The best strategy would be to integrate RPA based on your area of expertise.
Our healthcare automation solutions can help you in:
- Unsolicited information transfer and automated back office can help create a connected payer-provider network.
- It will help you normalize data for both parties which in turn will promote better care delivery.
- It will automate mundane processes to free up valuable time and increase data accuracy.
Connect with us to give your back office that much-needed upgrade. info@nalashaa.com
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Mitrajit Das
A writer with a keen interest in the Healthcare domain and B2B content marketing. He enjoys writing and creating pieces around the latest Healthcare IT trends using the simplest of words.
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