RPA In Healthcare

Healthcare businesses deal with large volumes of data that are collected from varied sources and in various formats. From patient data and clinical data to third-party application data and insurance data, the scope of data that healthcare businesses process is immense.Healthcare organizations can significantly benefit from adopting RPA solutions. RPA solutions help string together numerous internal silos to create a streamlined data flow system. This reduces the number of manually intensive work processes and enables a smooth flow of information between departments and between the organization and third parties.

Sample Process

Billing and Claims Processing

RPA helps healthcare companies gather data from various sources and process claims accurately and quickly, leveraging rules-based decision-making.

Patient Enrollment

Robotic Process Automation in healthcare helps capture patient information at the point of service accurately. It updates the data into the revenue cycle system resulting in increased clean claim transmission and timely reimbursement for services.

Eligibility Verification

Healthcare providers use RPA to receive data on patient coverage, out-of-network benefits, and other insurance information. It helps them submit clean claims while avoiding claim resubmission, reduce rejections/denials, and increase upfront collections.

Regulatory Compliance

RPA in healthcare plays a critical role in improving governance and regulatory compliance. It simplifies compliance by keeping detailed logs of automated processes, automatically generating the reports an auditor needs to see and eliminating human error.

Revenue Cycle

RPA enables healthcare insurers to integrate multiple systems and create solutions that identify code changes, ICD-9 code changes, code definitional changes, billing code changes, codes for disease classification and accelerate the revenue cycle turn around time.

Clinical Documentation

RPA helps healthcare providers in the creation of digital records detailing the medical treatment, medical trials, or clinical tests that are accurate, timely, and reflects the specific services provided to the patient.

Applications of RPA

Sales Order Processing

Letters of Credit Processing


Eligibility Determination