But across major health systems and independent providers alike, it’s the financial back office and billing departments where one of the industry’s most transformative shifts is underway.
The reason? Advances in robotic process automation (RPA), tailored to the uniquely challenging and fragmented compliance landscape in healthcare, are becoming cheaper to deploy and easier to integrate, helping streamline everything from patient registration to billing and collections.
RPA doesn’t diagnose cancer or save lives in the operating room. But it might be critical to keeping hospitals financially viable in an era of shrinking margins, mounting administrative complexity and heightened patient expectations.
After all, the revenue cycle is the circulatory system of healthcare finance. It spans front-end processes like verifying insurance coverage, through mid-cycle coding and clinical documentation, to back-end billing, denials management and collections.
Traditionally, healthcare revenue management and payments processing has been a labor-intensive, error-prone operation that can hemorrhage cash through administrative waste. That’s why, in a sector where the business of care often collides with the practice of medicine, RPA innovations can increasingly help hospitals stay solvent, patients stay informed and clinicians focus on care rather than paperwork.
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The Silent Revolution in Healthcare Operations
A recent report by PYMNTS Intelligence, “Healthcare Payments Need Modernization to Drive Financial Health,” illuminates how manual payment systems are hindering the efficiency and revenue generation of healthcare providers across the United States.
Every patient encounter can involve dozens of administrative steps, from prior authorization to claims submission. Staff shortages compound the problem. Since the pandemic, hospitals have struggled to retain experienced coders and billing personnel, leaving remaining employees overwhelmed by manual work.
According to the PYMNTS Intelligence data, over two-thirds (67%) of executives and decision-makers in healthcare payer organizations report that their firms’ manual payment platforms are reducing efficiency.
At the same time, payers have become more aggressive in scrutinizing claims, pushing denial rates higher and extending the time between service and payment. The rise of high-deductible health plans has shifted more of the cost burden onto patients, complicating collection efforts and creating more friction at the front end of the cycle.
The result is a system where billions of dollars are lost each year to errors, avoidable denials and write-offs. The inefficiency is not only financial but human. Staff burn out under the weight of repetitive tasks, and patients bear the brunt in the form of confusing bills, delayed care and long waits for approvals.
Robotic process automation brings a new tool to this administrative labyrinth. Rather than humanoid robots, RPA relies on software “bots” programmed to perform repetitive, rules-based tasks. Unlike artificial intelligence, which seeks to emulate human reasoning, RPA excels at executing structured processes quickly and without fatigue.
“We are in a unique time in history,” Autonomize AI CEO Ganesh Padmanabhan said during a discussion hosted by PYMNTS CEO Karen Webster. “Until large language models specifically came about, it was impossible to distill information out of complex medical clinical documentation and contextualize it for different workflows. Now it’s possible,”
In the context of revenue cycle management, RPA bots are used to check insurance eligibility, submit prior authorizations, code straightforward encounters, scrub claims for errors, track claim status and route denials for follow-up. These are precisely the types of rote, high-volume activities that drain human capacity. Bots can work around the clock, move data between disparate systems, and process transactions at a fraction of the cost of human labor.
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Moving Healthcare Back Offices Toward Intelligent Automation
Despite its promise, RPA is not without limits. Implementation often reveals messy realities. Hospitals frequently discover that their internal workflows are inconsistent or poorly documented, forcing them to standardize processes before bots can be applied. Once deployed, bots require ongoing maintenance. A simple change to a payer’s portal can break a script, halting automated workflows until IT teams intervene. Scaling automation from isolated tasks to full revenue cycle integration is complex and demands governance.
But it is becoming increasingly necessary as generational turnover reveals emerging behavioral expectations around the payment experience.
The latest PYMNTS Intelligence from the June 2025 PYMNTS Data Books report, “Clicks, Care & Copays—How Each Generation Navigates Digital Healthcare,” finds that, despite being digital natives, younger generations are technologically struggling to make basic healthcare payments.
And ultimately, the future of revenue cycle automation will likely go beyond standalone RPA. Many health systems are already moving toward “intelligent automation,” which combines the speed of bots with the adaptability of artificial intelligence. In this model, RPA handles structured data movement, while machine learning predicts which claims are most likely to be denied. Natural language processing extracts information from physician notes, while analytics provide dashboards that direct staff attention to the highest-value tasks.
This integrated approach shifts the revenue cycle from reactive to predictive. Instead of waiting for denials to arrive and then scrambling to fix them, health systems can anticipate where errors are likely and prevent them from happening. The revenue cycle becomes less a patchwork of fire drills and more a system of continuous optimization.
