3 Implementation Strategies for Claims Processing Workflow Automation

Healthcare organizations across the country are looking for ways to increase efficiencies that can streamline care, improve quality and reduce costs. To accomplish these goals, some hospitals have turned to automation, computer programs that can perform tasks otherwise done manually. While automation offers many benefits, some employees and staff may be resistant to this change. By empowering staff and using other strategies, however, hospital leaders can successfully implement workflow automation.

Automation offers several benefits to hospitals, including quicker processes, reductions in errors and cost savings. Automation has a "two- or three-fold benefit," says Reese Walker, lead financial systems analyst at Albany, Ga.'s Phoebe Putney Memorial Hospital. Mr. Walker's hospital has implemented the Boston Software Systems' Cognauto® software to automate a variety of manual processes. "You're saving yourself money [not only] by not having staff perform that task, but [also] by getting information quicker and money flowing back quicker." As an example, he says while sending information to an insurance company might normally take two to five weeks, automating that process could reduce the lag time to three to four days, which would allow hospitals to receive reimbursement faster.  

Workflow automation can also prevent errors in data entry. "Any time something is manual, there's a chance of somebody making a mistake. When people make decisions on [potentially erroneous] data, that's an opportunity for a bad outcome," says Thom Blackwell, vice president of technical services at automation software company Boston Software Systems. In addition to eliminating the potential for keystroke errors, automation can flag problems that may require a human, according to Mr. Blackwell. "Automation helps with day-to-day tasks. It's a series of very simple things. In aggregate, [however,] it's something very important," Mr. Blackwell says.

Implementation strategies
Mr. Blackwell and Mr. Walker offer the following strategies for successful implementation of workflow automation.

1. Raise awareness. Successful implementation of automation programs typically does not depend on specific technical knowledge, but instead on awareness of what automation can do, according to Mr. Blackwell. "The technology is not hard to use. Implementing [it] is not hard to do. What's more of a challenge is recognizing that it is a viable option to manual processes," he says. The degree to which automation can improve an organization's efficiency corresponds to the number of processes it performs. "Data entry almost always can be automated,” Mr. Blackwell says. However, automation can be used for myriad tasks that hospital leaders may not think of at first.

2. Program for exceptions. Mr. Walker says one strategy for successfully implementing automation programs is including exceptions to rules, as the computer translates codes literally. "Make sure you have every variant programmed for," he says. For example, Mr. Walker says he had to work closely with professionals in the billing department to automate their processes because he was not sufficiently familiar with all the exceptions and details that needed to be included in the program.

3. Empower staff. "Empower staff. Let them take ownership," Mr. Walker says. Phoebe Putney Memorial's leaders identified several initial tasks they wanted to automate and then invited staff to suggest other processes whose automation would benefit the system. Mr. Walker says this strategy led to many successful programs for automation, including programs for Medicaid work in progress reports, Medicare portal scripts and Medicare status checks. "[Employees] had pride in the fact that they came up with a solution to a problem," he says. Communicating the purpose of automation and the hospital's intentions in implementation can help leaders and staff work together to optimize the organization's use of automated processes.

Related Articles on Workflow:
10 Proven Ways for Surgery Centers to Improve Workflow Processes

ICD-10 Specificity to Impact Nurse Workflows

Squeezing Water From a Stone: How to Get More From Existing Capacity and Add More to Your Bottom Line

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars