What is Robotic Process Automation? What is the Application of RPA in Healthcare?

Are you tired of managing mundane and repetitive administrative tasks in your healthcare practice? Do you want to save time and increase productivity? Here is the solution: Robotic Process Automation (RPA). RPA is a type of software, known as bots, that mimics the actions of a human being to complete repetitive and mundane tasks, such as data entry, claims processing, and appointment scheduling. RPA technology is designed to work with existing systems and applications, making it easy to integrate into existing healthcare workflows.

Unlike traditional automation tools, RPA bots are intelligent and can learn from past actions, making them an ideal solution for healthcare organizations that deal with large amounts of data.

Throughout this article, we will discuss the various benefits of RPA in healthcare administration, including how it can save time and money for healthcare providers.

Benefits of Robotic Process Automation in Healthcare:

  • Improving Patient Care and Productivity
  • Increasing Efficiency and Reducing Costs
  • Promising More Scalability
  • Ensuring Data Accuracy
  • Enhancing Compliance
  • Ensuring Faster Processing
  • Optimizing Revenue cycle management (RCM)

RPA Use Cases in Healthcare:

1. Patient Intake

In healthcare management, patient intake is a critical step. However, when done manually, it can be time-consuming and error-prone as the patient information must be obtained from various sources and then inserted into the Electronic Medical Records (EMR) system. RPA automates this process simply and quickly.

2. Appointment Scheduling

Another essential component of healthcare administration is appointment scheduling. By interacting with the EMR system and delivering appointment reminders to patients, RPA can automate appointment scheduling. RPA can also reschedule appointments in accordance with the healthcare provider’s availability, lowering the chances of no-shows and increasing patient satisfaction. This can be automated for both new patients and existing patients.

3. Insurance eligibility verification

Insurance eligibility verification is a time-consuming task that requires checking the eligibility and coverage of patients’ insurance plans. Using RPA, this procedure can be automated from start to finish by getting information about the patient’s insurance coverage from the EMR system, confirming eligibility, and delivering real-time coverage information. This can help healthcare providers in Dallas reduce the number of denied claims and increase the chances of reimbursement.

4. Pre-authorizations

Pre-authorizations are an essential component of managing healthcare, especially when it comes to high-cost treatments. RPA can automate the pre-authorization process by collecting patient data, insurance coverage, and clinical documentation from the EMR system, and submitting it to the payer for authorization. This can enhance the chances of reimbursement and decrease pre-authorization delays and denials.

5. Physician notifications

Physician notifications are necessary for ensuring the continuity of care for patients as most of the patients tend to forget the follow-up visits or not come when symptoms alone disappear. RPA can automate physician notifications by sending alerts to physicians when patients’ conditions change – Results of medical tests – or when they need to review a patient’s medical records. This can help healthcare providers improve patient outcomes by reducing the risk of missing continuous check-ups.

6. Appointment reminders

Appointment reminders are crucial for reducing no-shows and improving patient satisfaction. Patients can be reminded of their upcoming appointments via tailored messages and given the option of confirming or rescheduling them with RPA. Appointments can be scheduled more efficiently this way, which can lessen the workload of staff members.

7. Billing and EDI automation

Healthcare providers need to spend time on Electronic Data Interchange (EDI) and billing to get reimbursed for their services. By creating invoices, filing claims, and tracking down unpaid claims, RPA helps automate the billing process. RPA also automates the EDI process more effectively, lowering mistakes and accelerating the time it takes to process claims.

8. Denial Management

Using RPA, claim denials will be automatically examined to determine the reason for rejection and, if necessary, an appeal will be generated. It can also track the status of the appeal and update the relevant stakeholders. This reduces the amount of time and effort spent on claim denials and improves revenue collection. As a result, claim denials take less time and effort to process, and revenue collection is improved.

9. Claim Submissions

RPA can be used to automate the entire claim submission process, from generating claims to submitting them to insurance providers. It can extract data from the EMR and billing systems and create claims automatically. This reduces the likelihood of errors and saves time and effort.

10. Claim Status

Using RPA, the status of claims can be tracked and monitored effectively and accurately, providing relevant stakeholders with real-time information. In addition, the time and effort required to monitor claim status can be significantly decreased because of this tracking method’s advantage in quickly identifying and resolving issues.

11. Insurance Follow-ups

Utilizing RPA, the automation of post-payment inquiries with insurance providers can be easily achieved. In addition, the extraction of data from the billing system and subsequent generation of automated follow-up messages to insurance providers significantly save the time and effort of healthcare providers.

12. Account Receivables

RPA can be used to automate the process of managing account receivables and payables. In account receivables, RPA extracts data from the billing system and automatically generates invoices and reminders for unpaid bills owed to the healthcare provider by patients or insurance companies for services rendered. By generating reminders for unpaid bills, RPI can help improve patient satisfaction. Patients may appreciate the timely reminders and the opportunity to pay their bills promptly.

Account Payables

In account payables, RPA follows the same steps as account receivables to remind the outstanding payments owed by the healthcare provider to vendors or suppliers for goods or services received. Maintaining positive relationships with vendors and suppliers is possible when payments are made on time and RPA always ensures reminders are sent on time. In healthcare, where supplies and services are crucial for patient care, this is of particular importance.
As well as by keeping track of outstanding payments, RPA can help healthcare providers produce a more accurate financial report.

EOB Posting

Insurance companies provide medical service providers with explanations of benefits (EOBs), which include information such as claim status, paid claims, the amount reimbursed & adjustments based on insurance agreements, secondary payers, benefits coverage, etc. The Report of EOBs is prepared manually. When documentation is done manually, it takes a lot of time to complete and is prone to errors. This is because every detail needs to be manually checked and entered, which can be a slow process.
RPA can automate the process of posting an Explanation of Benefits (EOB), which is accurate and time-saving as well as can be done quickly.

13. Request for Information (RFI)

The RFI process is critical for healthcare organizations as it helps them make informed decisions and provide better care to patients. The RFI process involves collecting information from various sources and generating a response within a specified timeframe. RPA can be used to extract data from various sources such as patient records and clinical trial data. This can help healthcare organizations gather relevant information quickly and efficiently.

14. Compliance and Audits

Healthcare organizations must comply with strict regulations and guidelines such as HIPAA and HITECH. The consequences of non-compliance can be severe, including hefty fines, legal fees, damage to reputation, and loss of business. Compliance tasks such as audits, risk assessments, and reporting can be automated using RPA implementation by extracting data from various systems. This can help healthcare organizations save from the consequences of non-compliance.


As the healthcare industry continues evolving, providers seek new ways to improve efficiency and reduce costs without compromising patient care. RPA technology provides an opportunity to achieve this, making it an attractive option for healthcare providers as it can work around the clock, seven days a week, and can complete tasks faster and with greater accuracy. By adopting RPA, healthcare providers in Dallas can stay ahead of the curve and provide better patient care while also reducing costs.

With Droidal – a Leading Healthcare RPA Company in Dallas, Healthcare organizations can access cutting-edge RPA technology and a wealth of experience to streamline their operations and improve patient outcomes.

Contact Droidal today for a free demo!

Vijay Sagar

Automation Analyst

Vijay Sagar M is a seasoned professional with a wealth of experience in Revenue Cycle Management (RCM), Robotic Process Automation (RPA), Project Management, and Six Sigma methodologies. As a Senior Business Analyst at Droidal, Vijay has consistently demonstrated his ability to bridge the gap between business needs and technical solutions, making significant contributions to the company’s success.


Customer Relation Management

Requirements gathering

Automation analyst

Process improvement

Budget & financial

Metrics reporting

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