innovating the manufacturing & logistics industry …webinar] using rpa to... · •identifies...

INNOVATING THE MANUFACTURING & LOGISTICS INDUSTRY WITH ROBOTIC PROCESS AUTOMATION

ENHANCING COVID RECOVERY WITH ROBOTIC PROCESS AUTOMATION

© JOLT Advantage Group 2018. All rights reserved.© JOLT Advantage Group 2020.

All rights reserved.

EXISTENTIAL THREAT IN THE HEALTHCARE SECTOR

The healthcare industry is facing unprecedented financial devastation due to revenue lossamid the COVID19 pandemic.

• According to this AHA report, the industry will lose $202.6 billion from COVID-19 expensesand lost revenue.

• Emergency room visits down

• Elective surgical procedures have largely been put on hold, multiple health systems report revenue losses of 50%.

• Providers expect lower revenue due to the drop in private employer-sponsored benefits from increased unemployment rates & lower reimbursement rates from Medicare/Medicaid.

Healthcare Industry’s Financial Downturn:

• 43,000 healthcare jobs lost in March and 1.4 million healthcare jobs were lost in April due to Covid19*

• Nurse unions has identified at least 200 hospitals nationwide cutting worker hours, mostly in the form of furloughs

Record Healthcare Job Loss:

As executives begin to plan for the recovery phase post-Covid19. Many are seeing the valueof Robotic Process Automation (RPA) as a key driver for business continuity, speed up theadoption of new operational standards, augment healthcare worker capacity, predict trendsbased on real-time data and generating a fast-financial recovery.

https://www.aha.org/system/files/media/file/2020/05/aha-covid19-financial-impact-0520-FINAL.pdf



ENHANCING COVID RECOVERY WITH RPA

IMMEDIATE RPA PRIORITIES IN HEALTHCARE

Robotic Process Animation (RPA) can be an invaluable tool to address COVID-related businesschallenges. To ensure rapid recovery, healthcare organizations must prioritize what should beautomated and when.

Step 1: Management Workflows

▪ Claims Submission

▪ Claims Status Checking

▪ Denial / Appeal Follow-up

▪ Payment Posting

Step 2: Drive Cash

▪ Identify and automate tasks not requiring face-to-face Interaction

▪ Facilitate remote work

Step 3: Remove Barriers to Patient Access

▪ Patient Sched/ Reg

▪ Ins. Verification

▪ Pre-Certs & Prior-Authorizations

▪ Triaging for Virtual vs. On-Site Visit

Step 4: Regulatory Compliance

▪ CARES Act monitoring

▪ Insurance Policy Changes

▪ Regulatory Requirements

Step 5: Patient Experience

▪ New Patient Workflows

▪ Financial Assistance Planning

▪ Longitudinal Personal Health Records



RPA can automate repetitive, high volume non-face-to-face healthcare tasks toallow people to focus on providing a better patient experience. The processesoutlined below also support other priorities such as eliminating barriers toaccess, driving cash and improving the patient experience.

STEP 1: MANAGE WORKFLOWS

Schedule the Appointment

▪ Register and Schedule Patients (Clinic, Labs, Diagnostics, Procedures, Surgeries)▪ Triaging Patients for Traditional vs. Telehealth Visit▪ Validate/ Verify Insurance▪ Obtain Documentation/ Forms▪ Collect Co-Pays and Past Due Balances▪ Provide Real-Time Cost Estimates▪ Submit Pre-Authorizations▪ Analyze Pt Payment Propensity▪ Enroll Pts for FAPs▪ Manage Referrals▪ Handle Pt. Calls

▪ Appt. Reminder Calls▪ Results Reporting Calls▪ Rx Refills

See the Clinician

▪ Exam and Diagnose Patient▪ Create Pt Treatment Plan▪ Order Labs, Diagnostics, etc.▪ Prescribe Medications▪ Document SOAP Notes▪ Review Lab and Diagnostic

▪ Reports▪ Sign/Close-out Notes▪ Manage Population Health▪ Comply with regulatory reporting

requirements▪ Manage Patient Compliance

See the Claim

▪ Review and Submit Insurance Claims▪ Follow-up on Ins. Denials and Appeals▪ Manage Claims Status and

Adjudication▪ Conduct Charge and Payment Audits▪ Respond to Pt Billing Inquiries▪ Post Ins and Patient Payments

▪ Perform Utilization Reviews▪ Comply with HEDIS & Regulatory

Reporting▪ Analyze Payment Propensity▪ Credential Physicians▪ Analyze clinical and other data



RPA increases revenue streams.

• Eliminates human errors. increasing standardization

• Expedites patient access

• Enhances Staff satisfaction

• Reducing operational costs

• Removes low-value work from the staff’s workload to increase worker satisfaction

STEP 2: DRIVE CASH

Process Heatmap – Revenue Cycle Management

Pre-Claim Pre-Visit VisitClaim

SubmissionInbox

Processing Payer Patient

Fee Schedule and Pricing

Contract Negotiation

Provider Credentialing

EDI/ERA Enrollment

Scheduling and

Registration

Appointment Reminders

Eligibility Verification

Pretreatment Authorization

s and Referrals

Precertification and

Adjudication

Plan / Enrollment

Patient Check-In

Co-Pay and Deductible

Payment Arrangement

Coding and Charge Capture

Encounter Documentati

on

Charge Entry

Claim Scrubbing

Claim Submission

Error Correction

EDI Management

Adjudication

Claim Intake

Mail Processing

Scanning and Indexing

ERA/EFT Processing

Payment Posting

Cash Reconciliatio

n

Accounts Payable

Claim Status Check

Denials Analysis

Requests for Information

Appeals and Resolution

Patient Statements

Patient Payment

Calls

Conveyance, Small

Balance

Patient Refunds

Transaction to Collections

278

271270

277

276

837

835

Pro

vide

rP

aye

r

High

Medium

Low

Automation Potential

Month End Closing

Reporting & Analytics

Information technology

Performance Management

ComplianceQuality

Management

RPA can be applied to drive revenue cycle processes as shown below in the heatmap for Revenue CycleManagement, highlighting processes that have high, medium, and low potential for automation.



See below a highlight of how many steps are involved prior authorization of a claim, RPA canaccelerate this processes, allowing for a faster claim processing.

STEP 3:

REMOVE BARRIERS TO PATIENT ACCESS

USE CASE: PATIENT APPOINTMENT SCHEDULING MADE SIMPLE

Healthcare institutions must collect personal information, diagnosis, and insurance details in thepatient registration process. RPA can automate patient data collection and processing. This way botscan optimally schedule patient appointments according to diagnosis, location, doctor availability,and other criteria. RPA can scan patient data to create a report that can be sent to a referralmanagement representative to fix the appointment. Additionally, RPA bots can notify patients whendoctors are unavailable for their appointment.

Bots can collect patient data and process it

RPA can help optimally schedule appointments

according to the patients’ data

Bots can notify patients of doctors' availability and

rescheduling

Physician orders lab test paper req

/ e-Order

Manually entered into the LMS

Benefits verification and eligibility are manually obtained via a

clearinghouse or payer portal

Check for PA requirements –Health Plans all have different

rules, are complex and constantly changing

Triggers manual work to contact health plan and retrieve plan-specific form. May require >30

min holding time

PA is submitted via faxed, portal or phone call after attaching

medical documents

If approved claim is billed

Lab staff continues to monitor status

After payer adjudication, lab is notified of patient financial

responsibility

USE CASE: STREAMLINING PRIOR AUTHORIZATION

Additionally bots can help with claims processing, physician credentialing by performing backgroundchecks, assisting with new hire onboarding, performing document indexing, doing NPI lookups, andvalidating the physician's education.



STEP 4: REGULATORY COMPLIANCETo comply with regulations and qualify for funding programs, payors andproviders must navigate auditing & compliance processes that are among themost unique and complex in any industry. They must concurrently managemultiple tasks involved in risk assessment and create a clear audit trail forreporting and compliance.

RPA Automates CARES Act Provider Relief Fund Reporting:

• Identifies all services provided under Medicare or to uninsured patients,financial statements, billing transactions, tax forms, etc.

• Sends risk assessment on patient safety and service quality to multipleparties for verification and approval.

• Avoids non compliance errors by RPA detecting and mending errors.

• Collects, evaluates and organizes multiple reports from different auditingtasks

• Collaborates with all concerned parties.

• Enables staff to monitor the progress of all reports, validates pendingapprovals.

• Creates an audit accountability for different auditing procedures and avoidcases of non-compliance.

Bots can record data and generate reports

Reports are automatically generated

and sent to involved parties

Hospital staff monitors the reports and can check on personnel

SECURITY & COMPLIANCE

ENCRYPTION EVERYWHERE256-bit Encryption — From network security to managing credentials

AUDIT EVERYTHINGCustomizable Log files capture everything; Provides non-repudiation

GDPR & HIPAA CompliantData is protected in the RPA platform at rest and transit



STEP 5: IMPROVE PATIENT EXPERIENCE

AUTOMATION CREATES A BETTER CLIENT EXPERIENCE:

Monitoring whether the patients follow discharge instructions, take theprescribed medications and manage symptoms properly is almost impossiblefor healthcare institutions. However those institutions are penalized

With RPA, automated workflows:

• Ensure the accuracy of discharge guidelines and send reminders to patientsabout prescription pick-ups.

• Notify patients about upcoming doctor’s appointments and medical tests.

• Alerts healthcare providers of patients in need of further assistance.

• Enhances their patient’s experience, provide better healthcare, and reducereadmissions.

• Improves of HCAHPS (Hospital Consumer Assessment of Healthcare Providersand Systems) scores.

Ensure post-discharge guidelines are followed by the patients.

Provide further assistance to patients after they leave the clinic or hospital

Reduce readminissions by keeping track of the patient's health status

Send reminders to patients about prescription pick-ups



GETTING STARTED:Step 1: Complete RPA Readiness Assessment

1. Do you currently have any RPA in use?

• If so, what use cases are already automated?

• If so, is it considered successful?

i. If so, why?

ii. if not, why not?

• If not, why not?

2. Do you currently have any RPA resources on your staff?

• If so, how many of what type?

• if not, do you want to build RPA knowledge in house?

3. What will a successful RPA program look like for you?

❑ Use RPA to create an enterprise program (automate as much work as possible)

❑ Use RPA to solve existing, well understood challenges

❑ Automate a backlog of RPA tasks

4. Have you identified and ranked all opportunities for automation?

5. How quickly do you want to unlock value?

❑ Immediately

❑ As soon as possible

6. What defines value for you?

❑ Financial

❑ Operational

❑ Clinical

7. Would you prefer RPA pricing that is:

❑ Fixed Fee

❑ Small, well defined packages

8. Where would you like to focus the initial RPA project(s)?

❑ Manage Services

❑ Drive Cash

❑ Remove Barriers to Access

9. Why do you want to start using RPA now?

You can complete theRPA Readiness Assessment

online or email this PDF page filled out to [email protected]

❑ Quality

❑ other?

❑ Monthly Managed Services

❑ Risk/Gain share based

❑ Regulatory Compliance

❑ Patient Experience

❑ Other?

https://www.joltag.com/rpa-readiness-assessment-questionnaire



RPAASSESMENT

RPA DEVELOPMENT & DEPLOYMENT

RPA COE MANAGEMENT

MANAGED SERVICES & BOT HEALTHCHECKS

OPTION 1: FAST START

OPTION 2: RAMP UP

OPTION 3: INSTITUTIONALIZATION

GETTING STARTED:Step 2: Choose 1 of the 3 Engagement Models

The RPA Fast Start is a packaged solution for organizations that are net new to RPA and is looking to ensure value realization while setting up the foundation for long term success.

The RPA Ramp Up is for organizations who already identified and ranked their top 10automation opportunities and is ready for JOLT to take over the development of theseworkflows and move them into a managed CoE and maintenance & support services.

The RPA Institutionalization package will provide end-to-end services for a full-blownautomation program that is scalable and optimized for enterprise institutionalization of RPA.

RPAASSESMENT


AUTOMATION OPERATING MODEL


MANAGED SERVICES & BOT HEALTHCHECKS

AUTOMATION OPERATING MODEL



Pay a fixed monthly fee to get your workflow automated in a turn-key manner. This includesimplementation, maintenance, licensing, monitoring and upgrades for a fixed fee. Lowersthe entrance fee for automation for most enterprises. Minimum commitment required.

Option 1: RPA as a Service (RPAaaS)

Entry Pack

Starter Pack

Enablement Pack

Scale Up Pack

6-8 weeks of ProServe, technical enablement, development of 2 Low to Medium processes, Infrastructure & Production Deployment

6-8 weeks of ProServe, technical enablement, Process doc + pipeline, development of 3 Low to Medium processes, Infrastructure & Production Deployment

7-9 weeks of ProServe, technical enablement, Process doc + pipeline, development of 5 Low to Medium processes, Infra & Prod. Deployment, COE with Active Operations Management

10-12 weeks of ProServe, technical enablement, Process doc + pipeline, development of 10 L/M processes, Infra & Prod Deploy, COE with AoM

UiPath sells bundles of licenses for new and ongoing clients packaged with professional services. Wematch the same packages with our US, MX and Blended rate card prices. Starter and explorer servicepackages align with UiPath’s pack pricing. With this model, we’ll enable you to start exploring whatUiPath’s automations can do for your environment, as quickly as possible!

Option 2: Packages

Option 3: Fixed Fee

Hire a full implementation team to work against your automation backlog or individualcontributors to fill key gaps in your workforce under a staffing augmentation model.

Align your business and RPA vendors interest by sharing in the profits realized byautomation!

GETTING STARTED:Step 3: Choose a Pricing Model

Option 4: Risk/Gain Share based



Our team will work as your guide towards real and sustainable digitaltransformation. We are passionate about agility and are driven to excellencewhen partnering with our clients to deliver unparalleled expertise inintelligent and robotic process automation, IT transformation, training andperformance support.

CONTACT US

[email protected]

(855) 238.5658

www.joltag.com

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innovating the manufacturing & logistics industry …webinar] using rpa to... · •identifies...

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