It is hard to picture Robotic Process Automation (RPA). There is nothing physical or tangible. There is no user interface that users interact with on a regular basis. In fact, when RPA is properly implemented, it works completely in the background without anyone noticing. That’s why the term RPA is nebulous for many people. What is it? How have organizations successfully deployed it?
Tidewater Physicians Multispecialty Group (TPMG), a network of over 250 physicians and advanced clinicians in over 85 offices across the Tidewater and surrounding areas, has successfully implemented RPA. The ROI was almost immediate, and their staff are pleased with the technology. RPA has made their revenue cycle process much more efficient and effective.
Healthcare IT Today sat down with Dinesh Pai, Chief Revenue Cycle Officer at TPMG and Nicholas Frenette, Executive Director of Product and Solutions Engineering at AGS Health to find out more about this successful RPA implementation.
RPA Defined
Gartner defines Robotic Process Automation or RPA as “a productivity tool that allows a user to configure one or more scripts – which some vendors refer to as ‘bots’ – to activate specific keystrokes in an automated fashion. The result is that the bots can be used to mimic or emulate selected tasks within an overall business or IT process.”
When combined with Artificial Intelligence (AI), RPA can do much more than execute the same actions repeatedly. With AI, RPA bots can decide the best actions to take based on the work encountered by the bot.
TPMG’s Penny Challenge
TPMG is a progressive physician group that has been accepting more value-based contracts. When submitting claims under these contracts, TPMG must provide quality codes along with the actual services and procedures conducted during an encounter. Most of TPMG’s payer partners accept these quality codes with $0 charges, however, several larger payers are not able to accept zero-dollar codes and will reject the entire claim.
To avoid this, TPMG places a $0.01 charge on quality codes for these payers. The payer does not pay the $0.01, they recognize that it is just a placeholder to facilitate the reimbursement process. However, these penny charges were a challenge for TPMG.
“We had a significant business problem because tens of thousands of these penny transactions were hung up in our accounts receivable,” explained Pai. “It complicated our ability to accurately bill patients and it prevented us from properly aging the entire visit because of this penny item sitting on that encounter. It basically prevented us from having a normal billing cycle.”
To get bills out to patients in a timely manner, the TPMG revenue cycle team had to go in and manually write off these penny charges so that their system could produce the bill.
After seeing several presentations on RPA at HIMSS Conferences, Pai felt that the technology could help automate the process of writing off these penny charges. He brought his idea up with AGS Health, TPMG’s partner for revenue cycle services, and together they began exploring the possibility of using RPA.
Implementing RPA at TPMG
Frenette was assigned to the project and began working with TPMG to better understand the scope of the challenge.
“RPA works very well when you have a clearly defined problem that is solved with a repetitive task,” said Frenette. “With TPMG, it was clear the financial adjustments that needed to be made, which systems needed to be updated, and the steps required to complete each discrete task. This is what made it a good candidate for RPA.”
The teams from AGS Health and TPMG spent a lot of time up front mapping out the systems and the steps involved. This careful planning paid off and in less than three months, they had an RPA process up and running to write off the backlog of penny charges and any new ones being generated.
Another key to the project’s success was the slow and measured roll out of RPA. They did not just “flip the switch” and have the technology tackle all the penny transactions at the start. They ran a series of small batches through the RPA tools and scrutinized the results. They adjusted as necessary before proceeding to the next, bigger batch.
When they were satisfied with the performance, they activated the RPA process which now runs silently and constantly in the background.
ROI and Overall Impact
The impact of the RPA solution has been immediate and significant.
“We’re definitely seeing more timely collections,” stated Pai. “We are also seeing an improvement in patient satisfaction. We no longer need to explain to some patients why they are receiving their bills so long after their visit with us. Our staff very pleased that they no longer need to do this work themselves. We have been able to shift staff to other areas that need their attention and expertise.”
Most important for Pai and other leaders at TPMG is helping staff focus on more meaningful work. Although their staff understood the need to write off pennies to properly send out bills, it was not a task that required their unique skills or expertise. Now that it is automated, staff are able to dedicate themselves to work that is more meaningful.
Watch the interview with Pai and Frenette to learn:
- The 4 keys to TPMG’s success with RPA
- The 3 things that organizations should do before implementing RPA to have a successful project
- Where TPMG intends to deploy RPA next
Learn more about TPMG at https://www.mytpmg.com/
Learn more about AGS Health at https://www.agshealth.com/
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