5 Ways Automation is Transforming the Medical Claims Industry

Written by Priya George

Content Writer

Automation in the claims processing software industry is no longer a future event. Recent research has revealed that the value of the claims processing software industry was $33.9bn in 2020 & is projected to reach $73bn in 2030. The pandemic played a large part in companies needing to introduce automation solutions for faster & more intuitive claims processing to save time, increase employee productivity & save losses.

Medical claims are vital data sources for the healthcare industry. With this data, organizations can keep track of services rendered, equipment used, transportation, pharmaceuticals, etc. In addition, based on the information provided in medical claims, insurances determine where and how they can reimburse clients. However, large volumes of this data can be overwhelming for insurance employees, where automated solutions that can process and transform the data into more digestible formats come in handy. RPA helps cut out repetitive operational tasks and focuses on high-value work. Watch our webcast now to learn how our hyper-automation solutions can help introduce intelligent claims processing within the insurance industry.

RPA: Key to Faster and Efficient Medical Claims Processing

Faster and improved medical claims processing and management are vital concerns for the healthcare and health insurance industry. RPA in claims processing helps rectify several challenges to claims processing, such as:

5 Ways Automation is Transforming the Medical Claims Industry

Manual input errors and inconsistency

5 Ways Automation is Transforming the Medical Claims Industry

Scattered input media

5 Ways Automation is Transforming the Medical Claims Industry

Problematic data retrieval

5 Ways Automation is Transforming the Medical Claims Industry

Difficulty managing compliances

Basic Automation often complicates matters as they rely on the quality of programming and manual input. With RPA, companies can access complete automation solutions. With robotic process automation, companies can work across all layers, including legacy apps, with zero disruption. In this blog, we aim to outline five ways Automation has transformed this industry:

  1. End-to-End Optimization

From the data entry process to organizing, transferring data, and detecting fraud, RPA bots can help streamline the entire claims process. With the speedy data transfer from one department to another, claims can be processed faster as employees do not focus on steps like claim validation and data execution.

  1. Automatic Scalability

During peak seasons, there can be an increase in workload, which can prove overwhelming for employees, especially when dealing with repetitive manual tasks. With the instant scaling of bots, claims can be processed without delay and stay completely accurate.

  1. Easy Data Entry

Due to RPA being integrated into the data entry process, information can be pulled from multiple sources. Thus, the time-consuming affair of filling in forms manually can be replaced with electronic records that are more durable and reduces the cost of data handling.

  1. Easy Audit Process

RPA, by quickly saving complete records and organizing them efficiently, managers can conduct instant checks and audits to ensure that no fraud is occurring. This ability to keep track of records also provides improved visibility to clients about the entire claims process, along with real-time claims updates.

  1. Reduce Administrative Burden

Medical claims processing is tied between the healthcare and insurance industry. With RPA, data entry can be automated, reducing the administrative burden placed on healthcare staff considerably. This also helps manage the revenue cycles more efficiently as a result.

A Review of RPA Tools and Services Available

Several platforms have built RPA solutions to revamp the medical claims industry. For instance, with UiPath Claim Processing’s automated claim verification, extraction, and integration of data from multiple sources, complex troubleshooting, error resolution, etc., companies can enjoy:

With Automation Anywhere, companies can leverage their “Digital Worker,” which combines RPA with AI/ML technology to augment human employee productivity and efficiency. With its pre-built, plug-and-play mode, companies can automate their intake, evaluation, and handle claims from various healthcare providers to extract relevant information and process invoices. Finally, with DataRobot, medical claims processing companies can build and deploy highly predictive models that detect which claims require manual inspection while auto-paying the remaining claims, which helps drive costs and increase customer satisfaction. While these advanced platforms can reduce work considerably, your company still requires the skilled expertise to implement these platforms successfully without incurring excess costs with minimal benefits. This is where our experts can help.

5 Ways Automation is Transforming the Medical Claims Industry

How Can Royal Cyber Help?

Our experts are best equipped to provide the RPA consulting and guidance needed to successfully build and implement automation solutions. Royal Cyber is a proud partner of automation leaders, Automation Anywhere, UiPath, and DataRobot. We provide various RPA solutions and support services across industries, including banking, real estate, retail, etc. However, in this blog, we would like to highlight our solutions in the field of:

Get in touch with us for a live demo, and if in doubt the feasibility and costs, don’t hesitate to get a free assessment or calculate your RPA expenses.