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Updated on:
August 22, 2023
November 14, 2022

Bots and Automation: The Future of Medical Billing

Febien Caltin is a dynamic professional with 20+ years of extensive experience in the healthcare RCM space. He has expertise in Consulting, and Strategic Planning on solving critical issues healthcare providers face in the RCM process. Febien is committed to the growth of healthcare providers through his immense experience.

ABA Providers Recover Dues From Patients To Efficient Your Account Receivables

Automation and bots are rapidly replacing manual work in medical billing. Tech-enabled medical billing services have significantly improved revenue for healthcare providers. In a survey published by macami.ai, it was found that 61% of US adults would prefer to leverage AI for medical billing to avoid errors. Healthcare providers that leverage AI are now able to concentrate on making analytical decisions and are able to spend more time serving patients.

AI technology is not just limited to medical billing. It enables healthcare providers to increase revenue by streamlining medical coding and other RCM services. We have put together a compelling blog for you that will emphasize the role of bots and automation in medical billing.

Here's how automation is streamlining medical billing

Efficient Data Management

Successful medical billing is dependent on the optimum utilization of data. There are massive data sets like patient demographic information, medical history & treatment plan details, insurance details, payer details, and more when filing a claim. Automation can swiftly gather, sort, and organize this data efficiently which makes it easy to use properly and source it, resulting in a high clean claim submission ratio.

Nonfictional Data Entry

Manual data entry is time-consuming and prone to errors. Even the most careful billers can make errors. It is human nature to reverse digits of numbers, copy down the wrong UX code, inadvertently forget to enter the correct code(s) and modifier(s). Bots and automation bring down medical billing errors and provide accurate data entry. Precision in data entry will enhance productivity and revenue from claims.

Comprehensive Data Analytics and Reporting

With the automation of data collection and sorting, analytics and reporting have become comprehensive and accurate. RCM automation enables real-time data visualization and analytics that helps to illuminate the business's financial health. This also provides very clear data to track RCM efforts and the returns on investing into AI.

Reduce Human Dependency

Automation minimizes the need for humans and saves time on erroneous prosaic manual tasks. It also improves quality and drastically lowers operational costs. The automation tool functions round-the-clock and can smoothly replace human billers. Medical billers can use the saved time and effort to do complex tasks that are not repetitive and routine tasks. This provides a dramatic improvement in collections for healthcare providers.

Manage Patient Schedule and Records

Automation gives easy access to patients' old records and data, which helps to schedule appointments, check for eligibility & benefits, draft patient statements, remind patients about payments, and more. It significantly reduces staff workload and provides patient convenience, resulting in high patient satisfaction and retention. The global patient engagement technology market will rise at a CAGR of 10% and reach USD 27.9 billion by 2027. Patients who are managed well are happier. They will pay faster and are loyal to the healthcare entities that provide a good patient experience.

Collection from Payers

Payers demand high accuracy at the time of claim submission. They require proper documentation, data, and medical codes to process the claim. Slight errors in documentation or data entry while submitting the claims have a drastic impact on reimbursements. Automation can track all the requirements from the payers and matches them with the claims to detect errors and missing information. Bots can eliminate all the manual coding and medical billing errors, which increases clean claim rates and allows for faster reimbursement on submitted claims.


Automation innovates and makes the medical coding and billing process more efficient. Partnering with the best tech-enabled medical coding and billing companies like Plutus Health will give you complete freedom to dedicate time towards patient care and pass on all the billing and collection stress to their experienced billers and coders.

Are you looking to outsource a tech-enabled medical billing partner? Our team of RCM experts has designed a solution that can automate the medical billing processes and the staff to focus on analytical and more complex tasks. Connect one of Plutus Health's medical billing specialists, and you will get a deep understanding of automation in medical billing.  

Key Takeaways:

  • Medical billing and RCM automation go hand in hand.
  • Companies spend billions on automation due to complex billing and claim submission requirements.
  • Claims and patient data reporting and analytics are more comprehensive due to automation.
  • Automating key medical billing processes saves considerable costs for healthcare providers and speeds up reimbursements for their services.

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Faq

What are the top workforce challenges facing ABA therapy providers in 2025?

ABA providers are grappling with high staff turnover (up to 65%), rising burnout, administrative overload, and stagnant reimbursement rates. These challenges directly impact care continuity, clinical outcomes, and operational performance.

How does operational inefficiency affect ABA organizations?

Operational inefficiency costs ABA teams up to 10 hours per staff member per week, contributing to burnout, denied claims, and longer accounts receivable (A/R) cycles. These inefficiencies ultimately result in reduced revenue and patient dissatisfaction.

Why is burnout in ABA clinicians considered a financial risk, not just an HR issue?

Burnout leads to costly turnover, lower client retention, and decreased productivity. Recruiting and replacing a BCBA or RBT can cost up to $5,000 per hire, plus months of lost revenue and disruption to morale.

What are effective strategies for improving ABA staff retention?

High-performing ABA organizations invest in clear career pathways for BCBAs and RBTs, align compensation with market benchmarks, and foster peer-led mentorship, flexible schedules, and wellness programs.

How can ABA organizations reduce the administrative burden for clinicians?

Automation tools like Plutus Health's Zeus streamline eligibility verification, denial management, and billing, reducing manual workloads by 5–10 hours weekly per clinician and improving clean claim rates by 95%.

What's the ROI of outsourcing RCM in ABA therapy organizations?

Outsourcing revenue cycle management can improve collections, reduce denials by up to 30%, and free clinicians from billing-related admin tasks, resulting in better client care and financial outcomes.

What's a proven example of operational transformation in ABA?

One $200 million ABA network partnered with Plutus Health to automate eligibility and accounts receivable (A/R) processes. The result: $2M reduction in legacy A/R and a 97% Net Collection Rate.

How can ABA organizations prepare for value-based care models?

By improving operational efficiency, investing in technology, and ensuring workforce stability, ABA leaders can align outcomes with reimbursement. Plutus Health supports this transition with scalable RCM and automation strategies.

Febien Caltin

Febien Caltin is a dynamic professional with 20+ years of extensive experience in the healthcare RCM space. He has expertise in Consulting, and Strategic Planning on solving critical issues healthcare providers face in the RCM process. Febien is committed to the growth of healthcare providers through his immense experience.

FAQs

What are the top workforce challenges facing ABA therapy providers in 2025?
How does operational inefficiency affect ABA organizations?
Why is burnout in ABA clinicians considered a financial risk, not just an HR issue?
What are effective strategies for improving ABA staff retention?
How can ABA organizations reduce the administrative burden for clinicians?
What's the ROI of outsourcing RCM in ABA therapy organizations?
What's a proven example of operational transformation in ABA?
How can ABA organizations prepare for value-based care models?

FAQs

What is ABA therapy billing?
What CPT codes are used for ABA therapy in 2025?
How do you bill Medicaid for ABA services?
What are common ABA billing errors to avoid?
How does credentialing affect ABA billing?

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