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DZone > AI Zone > RPA Use Cases in The Field of Healthcare

RPA Use Cases in The Field of Healthcare

RPA is considered to be an exploratory step for enterprises and organizations to move into the world of artificial intelligence.

Ruchi Jain user avatar by
Ruchi Jain
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May. 14, 21 · AI Zone · Analysis
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Many large healthcare organizations are adopting RPA leading to digitalization which can lead to healthy competition between medical services. The use of disruptive science and technology can make the healthcare industry more efficient. Using RPA can perfectly automate the query tasks of Electronic Health Record data, partner ecosystem, financial and accounting systems, and payment personnel letter, thereby reducing the workload of medical personnel.

In different industries, RPA is considered to be an exploratory step for enterprises and organizations to move into the world of artificial intelligence. According to the recent RPA report, increasing productivity and improving customer experience are the top priorities for organizations to adopt RPA.

RPA Healthcare

Currently, healthcare providers and professionals are looking for different ways to promote patient interaction, reduce costs, increase productivity, and increase operational efficiency.

Healthcare organizations face many challenges, especially when managing and processing multiple internal and external information exchanges. These include clinical applications, laboratory information systems, third-party systems, insurance systems, radiology information systems, scheduling applications, ERP and HR applications, etc. The integration of these systems is usually intricate, and most medical institutions still rely on the manual processing of this intensive information.

But with the help of RPA, many healthcare institutions can improve efficiency and provide better medical services to patients. Robotic Process Automation (RPA) can provide a lot of help for nursing staff, especially the following 5 points.

Claim Application

Generally, managing claims processing is a time-consuming task, including tedious tasks and collecting large amounts of data from different sources. If these processes are performed manually, it will cause human error, and may even cause the entire claim to be processed incorrectly. According to relevant reports, nearly 30-40 percent of health claims may be rejected due to non-compliance with regulations. Therefore, the use of RPA can extract defined and undefined data, update the system and simplify the claim application process.

Claim Application


Patient Appointment Registration

In today's Internet age, patients often register online and make appointments with doctors for medical treatment. Patient registration appointment is a very cumbersome data process, because health care organizations must collect patient data, diagnosis, social security, insurance details, etc. during the registration process. For patients, they must also wait for the doctor's outpatient time and ensure that their time is free to see a doctor. If it is necessary to be diagnosed by a neurologist or doctor related to the disease, the patient must check the doctor's time in the hospital.

Medical institutions can use RPA tools to solve problems related to patient registration and appointment. RPA robots can automate patient data collection and processing procedures, and choose the best appointment time for patients based on their diagnosis, doctor availability, location, and standards. It scans the patient data to create a report, which can be sent to the referral manager to confirm a valid appointment and notify the patient whether the doctor is available. In the case that doctor appointments are not available, RPA software can track the doctor's schedule to remind patients at all times.

Patient Appointment Registration


Pre Authorization

Pre-authorization is mainly to prevent excessive medical treatment. In almost all high-end medical and a few other medical insurances, some special treatment items need to be authorized by the insurance company in advance, and the insured must obtain some freedom rights in advance. Approved by the insurance company

Pre-authorization is an integral part of claim management. It is required to assess the medical necessity and cost-of-care ramifications. Any error can lead to claim denial. RPA bot can expedite manual entry, verification & monitoring with high accuracy

Pre Authorization


Invoice Processing

Invoice processing deals with the handling of various invoices coming from different vendors and sources. The invoice has different data and types which need to be handled properly. RPA can be a good tailor-made solution for tasks like invoice processing. RPA software irrespective of different formats can scan the invoices and then convert them into an image of a text-searchable document. RPA can capture range from an invoice to maintain error-free ERP data. 

RPA solution ensures that invoices are smoothly validated and approved with automated checks and minimizing or completely removing user intervention, to deliver high efficacy and efficiency for healthcare providers

Invoice Processing

Insurance Approval/Rejection Status Check

Insurance status checking is a time-consuming manual process. Sourcing and integrating information from various internal and external sources is a daunting challenge for healthcare organizations. With RPA, it can be transformed into a smooth and easy process.

Insurance Status Check

Healthcare Workflow Management

Managing and synchronizing medical care, cases, remote medical monitoring, and public health are important workflows in medical care. These workflows are usually manually managed, which is easy to cause human error and is a time-consuming and laborious task. Moving these routine tasks from manual services to RPA tools can bring cost savings and better services to healthcare organizations. In addition, this method can improve efficiency across the board. By automating such workflows, medical professionals can spend most of their time on patient care and other care facilities.

RPA software is essential to improve Hospital Consumer Evaluation System scores, and caregivers can improve the patient’s hospitalization experience, provide better treatment, and reduce readmission rates.

Healthcare Workflow Management

The RPA healthcare use cases designed above show the reasons for automation in the healthcare industry. They also provide directions for addressing the current challenges of the healthcare industry. By implementing RPA in healthcare the industry will be more solid, improve efficiency and free up employees to perform key tasks.

Robotic process automation Data (computing) application Task (computing) Insurance Processing IT Efficiency (statistics) Electronic health record

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