Robotic Process Automation In Revenue Cycle: A Report From The Front

By Ed Berenblum, Julia Dashuta, Adam Price and Jade Wanzek, Deloitte Consulting

Over the last couple of years we completed several robotic process automation (RPA) projects for healthcare providers. Some projects automated a single process that interacted with one internal technology platform, while others automated multi-step processes with complex decision rules that involved multiple internal and external systems. In particular, we recently completed the automation of the insurance and benefits verification, authorization and referral management processes within the front end revenue cycle for a multi-hospital system. This RPA instance interfaced with 14 internal and external systems, required the creation of 200 business rules, involved over 5,000 lines of code and replaced the work of 50% of the staff. This complex implementation will enable the hospital system to greatly expand the number of verifications it performs, with the same staff, and to reap the identified benefits of reduced denial rates, accelerated cash and reduced labor costs. This article summarizes some of our learnings from simple and complex implementations and describes key steps providers can undertake to reap the potential benefits of this technology.