Becker's Hospital Review recently spoke with Raj Sethuraman, chief product and technology officer at Finvi, about the importance of automation's role within healthcare revenue cycle management.
Question: Automation is an important thing in RCM. How do you think that is going to continue to grow?
Raj Sethuraman: Machine learning is going to play a major role in automation going forward. It is imperative that we continue to anticipate the challenges that patients will face in the future if we are going to help them overcome them. For example, it is incredibly helpful if we can correctly predict a payment plan and payment schedule that best fits the needs of the patient.
We must also use AI to create better, more holistic views of patients and to create payment and communication strategies. AI can help us determine the likelihood of a patient paying much more accurately than a simple credit score. Using alternative data points provides a fuller picture of a consumer, including their spending habits and interests. We can use this to determine how and when they spend money so we can more accurately develop payment plans and schedules into their lifestyle. And we can better determine which patients are most likely to pay, and collect from those accounts first. AI can also help us determine a patient’s preferred method of contact. Using their favorite channel makes it more likely that they will respond.
Robotic process automation (RPA) is also growing. If we automate payment reconciliation, transferring data between EHR and payment systems, and other manual tasks, imagine how much more efficient your agents could be. Automating these tasks allows agents to focus on more critical tasks that require a human touch, such as compassionately handling patient accounts to ensure payment. With the difficulties inherent in paying off accounts, the method and process should not be among them.
Of course, RPA and AI are not the only automations that save time. While AI is certainly exciting, other more-commonplace conventions, such as rules-based processes, can also be big time-savers. The key is building a strategic workflow so that you can move from point A to point B with as few manual steps as possible. At the end of the day, whenever you can make a manual process automatic, you will see benefits in the cost to collect.
Question: These strategies all sound good for patient pay, but what about other payers, such as insurance companies?
RS: The use of automation and intelligence is critical in how we interact with all types of payers, including insurance companies. AI can scan different payer websites to determine each payer’s specific requirements. Learning these patterns saves time for agents and, eventually, a workflow tool powered by AI can complete these types of repetitive tasks. Technology can also be used to group payer accounts together, allowing agents to address multiple accounts on one call. But using automation, you can not only group these accounts by payers, but also by the type of account and the type of inquiry that the agent wants to make. This ability could reduce agent hold times as they are transferred between departments.
Question: You mentioned preferred mode of contact. What do you think is next for patient contact methods?
RS: It’s no secret that the younger generations prefer digital contact, such as text or email. But a recent Finvi survey, conducted in partnership with YouGov, found that 70% of people 55 and older are comfortable paying bills online. Contrary to popular belief, older citizens are becoming more comfortable with digital channels, which is a positive as communication has become increasingly digital. And that is not changing. But what is likely to change is how much of this activity moves to text messaging. Our survey found that 42% of people between the ages of 18-34 prefer to pay via text. As text-to-pay technology becomes more sophisticated and this age group grows older, text will likely eclipse email as the most commonly used communication method.
Question: What does this mean for RCM?
RS: The most important point is that technologies must work together. When we understand who is paying and how they are paying, we need the tools to seamlessly update the account. People are busy and don’t want to wait. And they also don’t want to be contacted about a bill they already paid. This makes it more critical than ever to integrate different systems and multiple pieces of data into one platform that can easily keep accounts up to date. As technology continues to advance, RPA is only going to become better at achieving this with all-in-one workflow solutions that can easily communicate with your EHR.