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Case Study

UiPath Automation in Healthcare: Transforming RCM 

Client Profile

Our client is a leading provider in the healthcare industry operating hundreds of hospitals and clinics across the country delivering outstanding patient care. While the company already maintained sizable revenue cycle management (RCM) operations in the U.S. and Asia, U.S. labor shortages and offshore challenges had it looking for a nearshore partner in Latin America who could support its healthcare process automation journey.

Bussiness Challenge

Selecting the right partner to drive automation in healthcare

Like other healthcare organizations, the client’s RCM operations were ripe for automation: full of high-volume, multi-step, repetitive, and labor-intensive processes prone to errors and inefficiencies that can impact financial health and delay patient care.  

Interest in RCM automation is surging as staffing shortages, security challenges, and growing transaction times led to a 50% increase in healthcare administrative costs, a 2023 report from Council for Affordable Quality Healthcare Index (CAQH) Index found. When implemented properly, RCM automation and process improvement can save the medical and dental industries a combined $18.3 billion, the report states.

In addition, the frustrating, tedious nature of RCM work left the client’s U.S. operations struggling to attract and retain staff. More than 80% of RCM organizations struggle with labor shortages (2023 Becker’s Hospital Review and PwC “Healthcare Revenue Cycle Survey”). 

Automating RCM processes is projected to save healthcare providers 1.6 million to 3.2 million hours of work (UiPath “The Value of Automating Healthcare Administration Operations” workbook).  

The healthcare provider had established a Center of Excellence (CoE) to transform its business operations with cross-organizational healthcare automation – focused on enhancing efficiency, reducing administrative burdens, and speeding revenue recognition, with the end goal being to improve patient satisfaction without increasing operating costs. 

The client selected UiPath, the No.1 business automation platform, as the best solution for achieving its goals. But the tight labor market for automation talent in the U.S. convinced the client it needed a top-quality nearshore intelligent automation partner to help scale its extensive agenda – combining nearshore advantages like cost-effectiveness, real-time collaboration, and outstanding English proficiency with a deep pool of highly skilled AI and automation talent located in Latin America’s top tech markets.   

As a UiPath Platinum partner and pioneer of nearshore tech-led outsourcing, Auxis stood as the natural choice. The client had outsourced revenue cycle management work to  Auxis’ Global Delivery Center in Costa Rica after realizing its existing Asia-based delivery center lacked the right skill sets, geographic proximity, and cultural alignment to adequately perform complex healthcare activities.  

 The client’s leadership felt confident that Auxis had the knowledge, tools, and experience to successfully drive innovative, custom-built healthcare automation solutions across its enterprise – coming to the table with one of the most robust delivery platforms in Latin America, a proven track record navigating the complexities of healthcare process automation in the highly regulated industry, and deep experience customizing connections to insurance payor portals.

Solution & Approach

Using healthcare process automation to improve patient experiences

After the successful CoE built an appetite across the organization for automation, the client turned to Auxis to access a consistent pipeline of high-quality, cost-effective talent that would help it keep pace with accelerating demand.  

The Auxis team was tasked with building robotic process automations (RPA) for the client’s RCM processes spanning multiple business units, including payment compliance, health information management, dispute resolution, accounts receivable, patient access, etc. Auxis’ automation experts are involved in key phases of the client’s automation lifecycle, including: 

  • Discovery/requirements: reviewing process documentation, filling information gaps, and testing to check feasibility.   
  • Development: designing and developing solutions; Quality Assurance testing to ensure high-quality, reliable results; and moving automations to production. 
  • Hypercare: a four-day period of close monitoring and support after a new automation is placed in production before it is transitioned to the ongoing support team.  

Many of the client’s existing RCM processes shared a common structure: manually extracting information from different sources such as emails, shared drives, applications, and internal databases, and then uploading that data into various internal databases and enterprise resource planning (ERP) platforms for processing. Such administrative repetitive tasks consumed much of its RCM staff’s working hours, creating inefficiencies and increasing operational costs and the potential for errors. 

While many robotic process automation providers only offer technical expertise, Auxis brings the business knowledge to reimagine how this work could be done – designing automations that improve healthcare processes to achieve efficiency and deliver faster, more accurate results. Before designing automation workflows, the Auxis team proactively contributes to process optimization – removing redundant steps and making processes more efficient and effective.  

To date, Auxis has leveraged Robotic Process Automation in healthcare to create dozens of automations aimed at speeding up the backend processes powering multiple RCM activities at the client.  

Some key healthcare process automations the Auxis team has built include: 

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