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Revenue Cycle Automation

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Revenue Cycle Automation in Healthcare

Our robust Revenue Cycle Automation solutions streamline reimbursement, claims management, payer interactions, and denial prevention — enhancing financial performance while reducing administrative burden and accelerating revenue recovery.

Healthcare operations team reviewing revenue cycle processes
7x

ROI achieved within four months

through intelligent revenue cycle automation.

Challenges Revenue Cycle Automation Solves

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    Delayed revenue and reimbursement cycles

    Slow authorizations, claim handling, and payer follow-up can postpone cash flow and make recovery less predictable.

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    Denials, underpayments, and revenue leakage

    Missing information, incorrect coverage, and payer variance can lead to avoidable losses and repeated rework.

  • assignment

    Manual, repetitive administrative work

    Teams spend valuable time checking portals, updating claims, validating eligibility, and routing exceptions manually.

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    Fragmented processes across systems and payers

    Disconnected workflows make it harder to coordinate work consistently across EHRs, payer portals, and internal teams.

  • visibility_off

    Poor visibility into performance and bottlenecks

    Limited operational insight makes it difficult to see where claims, authorizations, and reimbursements are getting stuck.

  • groups

    Rising workloads and staff capacity constraints

    Growing volumes put pressure on teams that are already stretched, making it harder to scale without additional resources.

Benefits

  • task_alt_24dp_0000FF_FILL0_wght200_GRAD0_opsz24 (1)

    Increase productivity

    Automate repetitive administrative tasks and free healthcare professionals to focus on patient care.

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    Improve accuracy

    Reduce manual errors and ensure consistent, reliable process execution.

  • savings_24dp_0000FF_FILL0_wght200_GRAD0_opsz24

    Reduce costs

    Lower administrative overhead and make better use of existing resources.

  • groups_24dp_0000FF_FILL0_wght200_GRAD0_opsz24 (2)

    Scale without adding headcount

    Handle growing workloads efficiently while maintaining service quality.

  • sentiment_satisfied_24dp_0000FF_FILL0_wght200_GRAD0_opsz24

    Enhance patient experience

    Deliver faster, more responsive care by reducing administrative burden and delays.

Case Examples

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Intelligent Prior Authorization Automation

Intelligent automation reduces the burden of prior authorizations by streamlining workflows across payer portals, EHR work queues, and documentation processes.

Our solution integrates into existing systems, supporting authorization submissions, documentation retrieval, status checks, follow-ups, and exception routing. Organizations can automate the full workflow or selected steps based on need.

Case

A large healthcare organization implemented intelligent automation to verify prior authorization requirements for scheduled services and procedures. The solution now processes approximately 350 cases per day, saving an estimated 840 minutes daily — nearly two full-time employees’ worth of work.

By automating high-volume eligibility and authorization checks, staff can focus on complex cases requiring additional review and follow-up.

assignment_late

Professional Billing Eligibility Denials

Professional Billing (PB) eligibility denials often occur when updated insurance coverage is not yet reflected at the time of admission, creating mismatches between PB and HB claims. Our solution helps healthcare organizations identify the correct coverage, validate eligibility, update claims in the EHR, and resubmit claims automatically.

By automating repetitive investigation and rework tasks, organizations can reduce denials, accelerate reimbursement, improve staff productivity, and minimize revenue leakage.

Case

One of the largest academic health systems in the United States achieved a 7x ROI within four months by using our intelligent automation solution to identify correct coverage, update claims in the EHR, resubmit claims, and automatically route exceptions.

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Underpayment Reconsiderations

Underpayment reconsiderations occur when payers reimburse below contracted rates, requiring manual investigation and appeal submission. Intelligent automation streamlines this by identifying variances, generating reconsideration requests, and submitting them to payer portals.

This reduces manual workload, improves reimbursement, and increases efficiency across denial and revenue recovery teams.

Case

At one large academic health system, by implementing automation to submit underpayment reconsiderations, they achieved a 2.5x ROI within 4 months post go-live.

Get in Touch

Tom Herrmann

Tom Herrmann

North America – Vice President, Revenue Cycle Transformation

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Tom is a healthcare revenue cycle leader with over 20 years of experience across Patient Access and Revenue Cycle operations within large academic healthcare systems. He has led organizations in improving operational performance, increasing revenue, and enhancing patient financial experience. Tom is passionate about leveraging emerging technologies and intelligent automation to drive efficiency, improve revenue capture, and reduce denials across the Revenue Cycle.

+1 617 962 1409
thomas.herrmann@digitalworkforce.com
Jennifer Carmichael

Jennifer Carmichael

North America – Director, Revenue Cycle Automation

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Jennifer is a healthcare technology and revenue cycle professional with extensive experience supporting patient access and revenue cycle transformation within large academic healthcare systems. At Digital Workforce, she partners with health systems to implement intelligent automation strategies that improve financial performance, reduce administrative burden, and enhance patient and staff experiences. Jennifer brings deep expertise across Epic applications including ADT, Prelude, Cadence, Grand Central, and Benefit Engine.

+1 978 987 8664
jennifer.carmichael@digitalworkforce.com

Lindsey Hylwa

North America – Sales Director, Intelligent Automation

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Lindsey is Sales Director for Intelligent Automation at Digital Workforce, where she leads enterprise engagements across the US, helping organizations transform operations through automation, AI agents, and end-to-end process orchestration. She focuses on delivering measurable value in large-scale digital transformation programs with particular expertise in healthcare and regulated industries.

+1 919 880 4969
lindsey.hylwa@digitalworkforce.com