Transforming Revenue Cycle Management with RPA Technology

• $30M in Direct Adjustments Processed in Just 2 Weeks
• 300% Increase in Productivity
• 50% Reduction in Errors
  
  

Overview

A leading Northeast region primary care multi-specialty medical group with 100+ clinics partnered with GeBBS to revolutionize their Revenue Cycle Management. By integrating Robotic Process Automation (RPA) into their Accounts Receivable (AR) and Billing Solutions (BS), GeBBS re-engineered the revenue cycle to drive faster claim resolution, higher accuracy, and improved client satisfaction.

Opportunities & Challenges

The client had outsourced AR and BS operations to GeBBS, relying on manual processing and periodic quality checks. This arrangement presented several challenges:

• Delayed cash flow and revenue recognition
• A 30% volume increase over baseline with no additional ramp-up time
• A mandate to reduce headcount by 50% while maintaining support for business growth

These challenges underscored the need for a strategic transformation of existing processes.

Solution

Process Simplification, Redesign and Automation

GeBBS deployed 15 RPA bots to automate high-volume, critical tasks across AR and BS. The transformation entailed:

• Re-designing processes to simplify workflows and shift from manual operations to a platform-based management system
• Deploying bots to extract and process data from payor portals, ensuring seamless integration with existing systems
  
  

Key Automation Initiatives with RPA:

• Billing Solutions (BS): Automated payment posting and reconciliation processes, managing $20-25 million in checks error-free. This reduced the posting time per claim from 3 minutes to 50 seconds, with bots processing an average of 2,000 claims per day compared to 320 manually.
• Accounts Receivable (AR): Automated claims submission, adjustments, write-offs, and inventory management, achieving a handling time of 30 seconds per claim versus 15 minutes manually, with a 98% accuracy rate.
  
  

Outcomes

Accelerated Cash Flow and Enhanced Efficiency

•        Direct Adjustments: $30M processed in just 2 weeks, significantly accelerating the reimbursement cycle.

•        Productivity Boost: Automation enabled bots to handle 800-1,000 AR adjustments and 1,500-2,000 payment postings per user daily, far exceeding manual benchmarks.

•        Error Reduction: A 50% drop in errors ensured consistent quality and improved overall service delivery.

Key Takeaways

• A strategic blend of process redesign and automation can drive measurable improvements in operational efficiency.
• Scalable RPA solutions boost productivity and enhance accuracy, leading to faster claim processing and improved cash flow.
• Digital transformation in revenue cycle management not only delivers financial benefits but also strengthens client relationships.

Conclusion

GeBBS’ innovative RPA-driven transformation enabled the client to overcome operational challenges, streamline day-to-day processes, and significantly enhance overall service delivery in Revenue Cycle Management.

Client Testimonial

“Since implementing GeBBS’ RPA solution, our claims processing speed and accuracy have dramatically improved, resulting in faster reimbursements and a more efficient revenue cycle. This transformation has truly elevated our operational capabilities.”
— [Director of Billing & Collections]