The healthcare industry is in the midst of a radical shift toward the implementation of more software and AI technology in day-to-day operations. This shift is now beginning to impact the nature of hospital transactions as well. The current majority of transactions are processed via phone and fax, which has caused an obvious backup in administrative duties, often costing workers hours of better-redirected time. A recent increase in the use of payment automation by health systems, however, has shown to greatly improve the natural flow of administration, and the trend seems to only be expanding with the gradual modernization of hospital IT infrastructure.
In the last year alone, automated payments have jumped from 13% to 21% nationwide, a staggering increase that is giving a formulated push to create efficiency in the healthcare field. A report released by CAQH estimated that the embrace of AI-tech and automation in hospitals has saved a whopping $122 billion annually so far and has the potential to save another $16 billion with full automation.
A large majority of these projected savings would be the result of automating prior authorizations. Unfortunately, this is probably the most complicated part of the process. Many state agencies regulate how these claims are processed, often requiring manual intervention in the form of mailing or faxing information. Adversely, because there are currently no federal HIPAA regulations in place that state a specification for how payments should be processed, some fear that as they adapt to automated systems, they may be later required to change their platforms in the event of regulation from the Department of Health and Human Services.
Future regulation worries aside, the benefits of automating payments and records are clear to both medical professionals and administrators. Becker’s Hospital Review even named automation of medical claims as a top strategy for increasing the revenue cycle portability of the hospital industry. Automation ensures that payments are processed more quickly, getting health systems their owed money sooner. Besides the added manpower requirements for manual transactions, they are getting increasingly more costly. Automation technology, however, will only continue to decrease in price as technology evolves to be more efficient and reliable.