Business process automation in healthcare.

What is Business Process Automation? (And How Can Healthcare Facilities Use BPA?)

| No Comments

HealthWare Systems Blog

What is Business Process Automation?

(And How Can Healthcare Facilities Use BPA?)

Posted on Tuesday, March 17, 2020

Business process automation (BPA) is the digital transformation of organizational workflows. BPA utilizes technology to automate manual, repetitive, routine tasks and to streamline processes. BPA applies business logic to respond to events, make information “actionable,” and anticipate next steps to proactively manage workflow.

Benefits of Business Process Automation

Business process automation enables organizations to assign their valuable time and employees’ skill sets to other objectives while technology takes care of the monotonous, time-consuming, and routine operations for them.

In addition to time, BPA saves organizations money. It is a cost-effective way to increase efficiency and speed up workflow. Plus, digital transformation of business procedures reduces paper usage (making processes more budget and environmentally friendly).

By limiting the opportunity for human error, BPA also improves accuracy and prevents deficiencies.

Business Process Automation in Healthcare

HealthWare SystemsFacilitator is a business process automation platform created specifically for healthcare.

Facilitator can apply BPA to the following areas that affect the healthcare revenue cycle:

Business process automation in healthcare.

Facilitator is a BPA platform built specifically for healthcare.

Pre-Arrival – prevents integrity issues that can result in technical denials or underpayments.

Prior Authorization – automates authorization requests using 278 transactions, web-crawling, fax requests, and payer portals; automatically checks status of pending authorizations; monitors status changes that affect patients’ authorized benefits.

Insurance Verification – verifies insurance in real time; identifies potential restrictions that may impact reimbursement; finds any unreported coverage by searching top regional payers.

Medical Necessity Checking – verifies medical necessity in real time; shares results with referring physician; produces ABN for patient signature; provides automated updates of LCD and NCD rules.

Financial Assistance Screening – determines the likelihood that patients will qualify for financial assistance; manages documentation requirements and selects/completes application forms based on eligibility program(s) pursued.

Appeals Management – routes denial work object to appropriate team member for resolution; generates appeal letter or form specific to payer or denial type; assembles appeals package and submits appeal; eliminates hard copies.

Release of Information – securely captures, gathers, and sends medical records; eliminates hard copies.

Electronic Medical Forms – business rules determine the correct forms needed for every patient’s specific encounter, so employees no longer need to memorize selection criteria; pre-populates forms with patient demographics.

Order/Referral Management – fast-tracks pre-registration by ensuring accurate and complete physician orders are received.

Automated Messaging – reminds patients of upcoming appointments.

And More


Is “BPA” in Your Site’s DNA? 

Business process automation is increasingly necessary for the success of today’s organizations, including those in the healthcare field. Through BPA, hospitals and health systems can streamline workflow while lowering costs, better allocating resources, and increasing accuracy.

Request a live demo to learn more about how you can transform workflow at your healthcare facility using business process automation.


By Stephanie Salmich

Physicians hold a thumbs up sign for solutions that can streamline prior authorizations.

Streamline Prior Authorizations with a Pre-Arrival Workflow Solution

| No Comments

HealthWare Systems Blog

Streamline Prior Authorizations with a Pre-Arrival Workflow Solution

Posted on Monday, July 1, 2019

The results of a recent survey conducted by the American Medical Association illustrate the importance of solutions that can streamline prior authorizations.


The 2018 AMA Prior Authorization Physician Survey found the following:

  • 91% The percentage of physicians who say the prior authorization process postpones patients’ access to necessary care.
  • 28% The percentage of physicians who say the prior authorization process has resulted in a serious adverse event for their patients (e.g., “death, hospitalization, disability/permanent bodily damage, or other life-threatening event”).
  • 86% The percentage of physicians who describe prior authorization burdens as high or extremely high.
  • Almost 2 Business Days (14.9 hours) The average length of physician/staff time that is devoted to prior authorization requirements per physician per week.
  • 36% The percentage of physicians who have employees who work solely on prior authorization tasks.

Clearly, health systems face many challenges related to preauthorization.  Patient safety is compromised when care is delayed.  Patient and physician satisfaction are at risk as patients endure frustrating waits for treatment and physicians deal with administrative duties that disengage them from their medical work.

And not only can each prior authorization be costly, but excess costs are also incurred in the forms of extra clerical staff and rework when prior authorizations are denied and must be resubmitted.


According to CAQH CORE, 88 percent of prior authorizations are completed either partially or completely manually; and, the majority of preauthorization issues are related to manual processes.

A pre-arrival workflow solution can automate manual processes and streamline prior authorizations.


With a pre-arrival workflow solution that can streamline prior authorizations, you can address the issues mentioned above:
Physicians hold a thumbs up sign for solutions that can streamline prior authorizations.

A pre-arrival workflow solution can streamline prior authorizations and improve staff and physician satisfaction.


Support your physicians by utilizing solutions that make their jobs easier.  Implementing time-savers for physicians can go a long way toward reducing physician burnout, which is often related to stressful and time-consuming administrative workloads.

In addition to increasing physician and employee satisfaction, a pre-arrival workflow solution will improve your revenue cycle and patients’ access to care they need.

Hospitals can no longer afford to delay employing solutions that will streamline prior authorizations and benefit all stakeholders in their organizations.


By Stephanie Salmich

A nurse speaks with an elderly patient: Directing assistance toward at-risk patients can reduce hospital readmission rates.

8 Ways to Reduce Hospital Readmission Rates

| No Comments

HealthWare Systems Blog

8 Ways to Reduce Hospital Readmission Rates

Posted on Wednesday, May 2, 2018

There are many ways facilities can reduce hospital readmission rates while producing better health outcomes for patients and avoiding CMS reimbursement reductions.  As the study “Reducing Hospital Readmission: Current Strategies and Future Directions,” published in the Annual Review of Medicine, aptly recommends, these strategies to reduce hospital readmission rates are best used in conjunction:

“The effect of interventions on readmission rates is related to the number of components implemented, whereas single-component interventions are unlikely to reduce readmissions significantly.”

Here are 8 ways to reduce hospital readmission rates at your facility:


A nurse speaks with an elderly patient: Directing assistance toward at-risk patients can reduce hospital readmission rates.

Directing assistance toward at-risk patients can reduce hospital readmission rates.

1. – Focus on delivering quality care.  Ensure that avoidable readmissions are not due to preventable errors on the part of your facility.

2. – Determine the cause of readmission.  As RevCycleIntelligence states, “Understanding why a patient returns to the hospital after discharge is key to preventing readmissions and solving challenges of follow-up care.”  Is the reason for readmission condition-related or are other factors at play (see #3)?  Was the hospital readmission unnecessary and/or preventable?

3. – Screen for at-risk patients.  Certain conditions, such as heart failure and pneumonia, have higher hospital readmission ratesSocial factors that can affect hospital readmission include housing instability, tobacco use, alcohol/drug abuse, malnutrition and access to nutritious food, access to reliable transportation, health literacy, social support, language barriers, and psychiatric disease.  Assistance may be best directed toward patients most vulnerable to readmission.

4. – Address no-show appointment issues to encourage at-risk patients to keep the follow-up appointments that may lower their chances of hospital readmission.

5. – Improve the discharge process.  Patients and their caregivers face much uncertainty upon leaving the safety net of the hospital environment.  Take the time to thoroughly explain instructions for at-home care before they are discharged; follow-up with phone calls or home visits to again confirm their understanding and give them an opportunity to ask questions.

6. – Take advantage of telehealth opportunities.  Telehealth devices enable clinicians to monitor discharged patients’ health at home and can help reduce patients’ uncertainty about whether or not they need to revisit the hospital.

7. – Improve the transition process between facilities.  Just as when a patient is moved from the hospital to home, moving from one facility to another can result in poor health outcomes and/or readmission if the transition does not go well.  Follow one of the transitions of care models, many of which employ a care team to coordinate effective transitions and have been proven to reduce hospital readmission rates.

8. – Establish true interoperability.  Better communication (in the form of successfully and consistently electronically sending, receiving, finding, and integrating/using data) is needed between facilities for proper care transition (and even across departments within the same facility).  Without it we risk patient safety and increase the likelihood for medical errors that affect readmission rates, such as adverse drug events due to inaccurate medication reconciliation.

Reduce Hospital Readmission Rates with a Multi-Strategy Approach


Again, the most successful efforts to reduce hospital readmission rates and create better health outcomes will utilize numerous strategies.  As the study “Reducing Hospital Readmission” in the Annual Review of Medicine concluded:

“Effective interventions share certain features: having multiple components that span both inpatient and outpatient settings and delivery by dedicated transitional care personnel. New evidence suggests that the number of components in a care transitions intervention is significantly related to its effectiveness . . . which strengthens the argument for more robust interventions.”


By Stephanie Salmich

GO GREEN and lower hospital costs.

Go Green to Reduce Hospital Waste & Lower Hospital Costs (Part 2 of 2)

| No Comments

HealthWare Systems Blog

Go Green to Reduce Hospital Waste & Lower Hospital Costs (Part 2 of 2)

Posted on Wednesday, August 16, 2017

Last week we discussed the effects of staff education on helping you reduce hospital waste and lower hospital costs. Below are two more strategies to help you achieve these goals.

“Green” Supplies

GO GREEN and lower hospital costs.

“Green” supplies can lower hospital costs in the long run.

Many hospitals have increased their use of disposable medical supplies that hamper hospital and environmental sustainability efforts.  Health facilities can be drawn to single-use items that seem more convenient and cheaper upfront, but may cost more than “greener,” reusable items in the long run.

Practice Greenhealth’s Cost of Ownership Calculator can help you compare products and choose those with the lowest costs and smallest environmental impact.  This tool looks beyond the price tag of an item to examine every cost a hospital will incur during the “acquisition, use, maintenance, and disposal” of the product over its lifetime.

There are some items that you cannot avoid purchasing in disposable form, due to patient safety concerns and health regulations.  But where possible, reprocessed equipment can reduce hospital waste and lower hospital costs.

Paperless Healthcare Solutions

Besides tossing disposable supplies, how much paper is your facility throwing out?  From completing registration paperwork and consent forms, to obtaining physician referrals and third party documents, hospitals are responsible for a great deal of paper consumption.  Fortunately, there are paperless healthcare solutions for managing each of these tasks:

1.)  You can automate patient registration by setting up a paperless registration system that is better for the environment and makes the registration process more accurate and efficient.

2.)  With an electronic healthcare forms library, there is no need to stockpile pre-printed forms that may go unused. Any form can be easily printed on-demand and updates to forms can be made electronically and in real-time, saving you from the cost and waste of destroying old versions that can no longer be used due to new revisions.  The need for blue cards and labels is also eliminated thanks to barcode automation.  Patients can even sign consent forms using electronic signature on electronic healthcare forms.

3.)  A physician order management system can help you electronically organize all incoming orders and referrals, regardless of source. Read here how one hospital reduced its paper usage by 1.3 million pages per year and eliminated 18,333 folders by going paperless with the solution ActiveXCHANGE.


Not only will these strategies help you reduce hospital waste and lower hospital costs, but they will also increase your appeal to today’s consumers and top job candidates who are attracted to organizations that practice corporate social responsibility.  Establishing environmentally-friendly policies and procedures is an excellent way to do your part in protecting our world while also ensuring the sustainability of your own facility.

Editor’s Note: This is Part 2 of a two-part blog series.


By Stephanie Salmich

GO GREEN to reduce hospital waste.

Go Green to Reduce Hospital Waste & Lower Hospital Costs (Part 1 of 2)

| No Comments

HealthWare Systems Blog

Go Green to Reduce Hospital Waste & Lower Hospital Costs (Part 1 of 2)

Posted on Wednesday, August 9, 2017

There is a dire need to reduce hospital waste.  The U.S. healthcare industry is accountable for 8% of our country’s carbon dioxide emissions, according to a study featured in the Journal of the American Medical Association (JAMA), and estimates of its waste production are as high as 5.9 million tons of garbage each year.

Going green is not only good for the environment, but also for your healthcare facility’s bottom line.  Researchers at the University of Illinois Chicago project the healthcare industry could save more than $5.4 billion over five years and $15 billion over 10 years by adopting more sustainable practices.

Below is one strategy to consider to help your facility reduce hospital waste and lower hospital costs:


Staff Education

A recent study of surgeries performed at UCSF Medical Center, published in the Journal of Neurosurgery, found that a startling number of packaged surgical supplies were opened but ended up unused and then thrown out after surgery.  The researchers calculated that these wasted medical supplies could cost UCSF $2.9 million dollars a year, and that only accounts for the waste from one department.

GO GREEN to reduce hospital waste.

Providing price transparency for your medical staff can reduce hospital waste and lower hospital costs.

You can reduce hospital waste by ensuring your medical staff handle their supplies in the most cost-effective and environmentally-friendly way possible.

To help doctors better gauge their role in hospital spending, the authors of the UCSF study recommend providing them with feedback on the costs of their procedures compared to the costs of their peers’.  This can also motivate doctors to reach a higher level of performance at a lower cost than a colleague or the potential competition.

Additionally, they suggest assessing surgeons’ lists of requested instruments on their preference cards before their procedures, eliminating nonessential items, and advising which ones should only be opened as needed (rather than at the start of the procedure) so that they can be saved for future use if unopened.

Many physicians are unaware of the cost of their equipment, but once enlightened, they find ways to use less expensive tools to do the same job.  Canadian hospitals are seeing huge savings using this tactic.  According to the National Post, Toronto Western’s neurosurgeons decreased their spending on disposables by 30% and saved $750,000 in the time span of four months.

Providing price transparency for your medical staff can pay major dividends, and their economical approach to medical supply use offers the added benefits of lowering patients’ bills and enabling your facility to treat more patients as well.


In next week’s blog, we will offer two more strategies to help you reduce hospital waste and lower hospital costs.

Editor’s Note: This is Part 1 of a two-part blog series.


By Stephanie Salmich