5 Essentials for Adopting Revenue Cycle Automation

February 2, 2023

Programmer working in a software developing company office

With many healthcare systems looking to adopt automation technologies in their revenue cycle, R1 has been answering numerous questions about how best to navigate automation projects. To go beyond the buzz and get into what organizations need to consider, our team has put together five essentials plus a bonus tip to help chart the right course and avoid unnecessary bumps along the road.

1. Pick the right problems to solve.

Health systems should start their automation strategy off right by choosing an area with many consistent processes, such as appointment waitlist management or handling of COB denials. Though it may be tempting to automate the process from beginning to end, it often works best to use the 80/20 rule, using automation to support the part of the process that follows a standard and predictable workflow, the 80%, and leaving the unique parts or exceptions, the 20%, for staff to address. This allows your organization to still realize automation’s benefits while simplifying your endeavor and channeling valuable staff resources into more strategic work.

2. Prioritize which problems to solve first.

Once the problems are identified, prioritize them. Processes that deliver qualitative benefits such as improving patient or provider satisfaction are often good places to start and can provide quick wins that build confidence and buy-in while still freeing up staff to work on more complex problems.

3. Appoint an automation champion.

When embarking on an automation journey, it’s best to designate a leader who will be enthusiastic about change, communicate effectively and can inspire confidence in internal stakeholders such as the revenue cycle team, IT, compliance and internal audit. However, no one person is an island, and commitment from the entire revenue cycle team is necessary. Therefore, the champion will want to get buy-in early by gathering team members’ input, crowdsource ideas and get IT comfortable with the endeavor, possibly by selecting an initial use case that doesn’t require heavy IT involvement.

4. Ensure the automation technology is optimized for your internal systems.

Your organization will achieve value faster and avoid high maintenance costs if the automation technology is optimized for your EHR and patient accounting systems. Trying to adapt a sub-optimal tool to perform a function that it wasn’t purpose-built for may be penny wise but pound foolish. Consider the total cost of ownership, not just the cost of the technology, when scoping automation projects.

5. Understand the value automation will create.

Return on investment from automation comes in many forms, and your team should set expectations upfront. While automation often is associated with labor savings, try to look beyond that. There are excellent use cases that improve consistency, quality, patient satisfaction, timeliness of service and denials prevention, all of which significantly impact the revenue cycle that can’t be quantified under the labor savings umbrella.

Bonus: Evolve and optimize automations, leveraging artificial intelligence.

With automation technology, it should never be just set it and forget it. Best-in-class healthcare systems apply artificial intelligence to data and insights derived from automations to improve other processes. For example, when a robotic process automation (RPA) script repeatedly checks to see if an authorization was issued, the results from those searches can be run through a machine learning program to identify patterns. If the program learns that authorizations submitted on Mondays get processed in 36 hours, while authorizations submitted on Wednesday are not approved until the following Monday, those insights can likely lead to other scheduling process improvements.

By taking a thoughtful, measured approach using these essentials for adopting automation technologies, organizations can achieve faster time-to-value and build momentum for a long-term automation journey.


You can learn more about automating your revenue cycle with these additional resources:

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