Automation could expedite hospital claims processing

Leveraging business process automation techniques may help healthcare facilities deal with increased scrutiny from recovery audit contractors, Becker's Hospital Review reports.

Implementing cloud-based systems or software-as-a-service can help expedite claims processing while improving accuracy levels and decreasing the amount of training and support staff needed to be able to complete tasks effectively.

According to Sal Novin, CEO of Healthcare Productivity Automation, manual claims processing can have up to a 30 percent variance, in contrast to the 1 percent produced as a result of automated processing. Additionally, automation allows complex claims to be more easily managed. This is likely to reduce the percentage of variance between claims, decreasing the likelihood of an RAC audit, the news source reports.

Automation can also help hospitals deal with cyclical volume changes, for example those that can take place during flu season

"The risk is that (healthcare facilities) may miss high dollar claims or make mistakes on them as a result of … less expensive, but high volume issues that occur seasonally," Novin told the news source.

The American Hospital Association's RACTrac report for the first quarter of 2011 found that almost half of respondents reported a rise in their administrative costs as a result of RAC activity.

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