Prior auth submissions taking days of staff time per week across your practice?
Claims rejection rate driven by manual data entry errors your team has to resubmit?
RPA in Healthcare
Healthcare staff spend a significant portion of their day on administrative tasks that deliver no clinical value. Prior authorisations submitted manually to payer portals. Patient records reconciled between systems that don't talk to each other. Insurance claims prepared, checked, and filed by hand. Compliance reports assembled from data spread across multiple systems.
We build robotic process automation systems that handle these workflows automatically -- claims processing, EHR data entry, prior auth submissions, and billing reconciliation -- so clinical and administrative staff focus on patient care instead of paperwork.
Claims processing and prior authorisation automation for payer portals
EHR data migration and cross-system patient record reconciliation
Billing and revenue cycle automation that reduces accounts receivable days
HIPAA-compliant automation architecture with full audit trails
RaftLabs builds robotic process automation systems for healthcare organisations -- claims processing, prior authorisation submissions, EHR data entry, patient record reconciliation, and revenue cycle automation. Healthcare RPA systems handle high-volume, rule-based administrative tasks that currently consume clinical and administrative staff time, with HIPAA-compliant architecture and full audit trails. Most healthcare RPA projects deliver in 8--12 weeks at a fixed cost.
Administrative burden is a patient care problem
Every hour a nurse spends reconciling records is an hour not spent with patients. Every prior auth your billing team submits manually is a task that a bot can do faster and with fewer errors. The administrative overhead in healthcare isn't just a cost problem -- it's a capacity problem.
RPA doesn't replace clinical judgment. It replaces the repetitive, rule-based work that surrounds it -- the data entry, the portal submissions, the status checks, the report assembly -- so your staff has more time for the work that requires a human.
Healthcare processes we automate
Insurance claims processing
Automated claims preparation, submission to payer portals, status monitoring, and rejection handling. Bots extract patient and encounter data from your EHR, complete payer-specific claim forms, submit via portal or EDI, and check claim status on a defined schedule. Rejected claims are flagged with the rejection reason for staff review. The claims workflow that reduces days in AR and submission errors without adding headcount.
Prior authorisation automation
Automated prior auth request submission across payer portals. Bots pull patient demographics, diagnosis codes, and clinical justification from your EHR, complete payer-specific authorisation forms, and submit requests automatically. Status checking on a schedule with escalation to staff when authorisation is not received within expected timeframes. The workflow that takes prior auth from a 30-minute manual task to a 5-minute exception-review process.
EHR data entry and migration
Automated data entry from intake forms, referral documents, lab results, and external records into your EHR. Cross-system patient record reconciliation when data exists in multiple systems. Bulk data migration for practice acquisitions or EHR transitions. Bots that handle the structured, repetitive data entry that consumes medical admin time -- so staff focus on the unstructured and exception cases that require judgment.
Revenue cycle automation
Automation across the revenue cycle -- eligibility verification at time of scheduling, co-pay and deductible lookup, claim submission, denial management, and payment posting. Bots verify patient insurance eligibility before appointments, flag issues for staff before the visit, and automate the post-visit billing workflow. The revenue cycle that reduces write-offs and shortens the time from service to payment.
Compliance and regulatory reporting
Automated assembly of compliance reports from data across multiple clinical and administrative systems. HIPAA compliance monitoring, quality measure reporting, and payer-specific data submissions. Scheduled reports generated and delivered without manual data assembly. Audit trail documentation maintained automatically. The reporting that keeps your practice compliant without requiring a staff member to spend days pulling data each reporting period.
Patient communication workflows
Automated appointment reminders, recall notifications, and follow-up communications triggered by EHR events. Prescription refill notifications, lab result notifications, and post-visit follow-up sequences. Multi-channel delivery -- SMS, email, and patient portal -- based on patient communication preferences. The outreach that improves show rates and patient engagement without additional staff time per outreach.
Tell us which administrative process costs your team the most time.
Process, volume, and current system. We'll design the automation and give you a fixed cost.
Frequently asked questions
The best RPA candidates in healthcare share three characteristics: they're high volume, rule-based, and currently done by people copying data between systems. Top candidates include: insurance claims submission and status checking (bots submit to payer portals, check status, and flag rejections), prior authorisation requests (bots complete payer-specific forms using patient and clinical data), EHR data entry from intake forms or referral documents, patient scheduling and reminder workflows, pharmacy benefit verification, and compliance and regulatory reporting that requires data aggregated from multiple systems.
Healthcare RPA must be implemented with HIPAA compliance as a design requirement, not an afterthought. We build RPA systems with access controls that limit data exposure to only what each bot requires, encrypted credential management (no hardcoded passwords), full audit logs of every action a bot takes including what data it accessed and modified, and secure data handling in line with your existing HIPAA policies. The RPA system inherits the compliance posture of the systems it accesses -- we document the data flows and help ensure the implementation meets your compliance requirements.
We integrate with EHR systems via three approaches depending on what your system exposes: UI automation (the bot interacts with the EHR interface as a user would -- useful when no API exists), API integration (where the EHR exposes a FHIR or HL7 API, we use it directly for more reliable data access), and database integration (for on-premise EHR systems where direct database access is available and appropriate). Common EHR systems we've worked with or around: Epic, Cerner, eClinicalWorks, NextGen, and Athenahealth. The integration approach is determined during scoping based on what your specific EHR version exposes.
Claims submission automation typically reduces processing time from 8--12 minutes per claim (manual) to under 60 seconds (automated), with error rates dropping from 5--10% to under 1%. Prior authorisation workflows that take 20--40 minutes of staff time per request are typically automated to under 5 minutes of bot-handled work with a human review step for exceptions. Revenue cycle teams report 30--50% reduction in time spent on routine billing tasks. The actual savings depend on your current process, claim volume, and payer mix.
A focused healthcare RPA system -- one process automated (e.g., claims submission to 3 payers), including bot development, testing in your environment, and deployment -- typically runs $20,000--$50,000. Multi-process automation programmes covering claims, prior auth, and EHR data entry run $50,000--$120,000. Cost depends on the number of processes, payer or system complexity, and integration requirements. We scope every project before pricing it.