Lesson 01: Build a Governance Structure That Actually Works
Your automation program needs a dedicated team with clearly defined roles. This includes decision-makers who can approve initiatives, strategic thinkers who align projects with organizational goals, technical experts who understand the platforms, and subject matter experts who know the processes inside and out.
Create a team charter that documents the program's scope, goals, members, roles, KPIs, and decision-making guidelines. This document sets expectations and helps prevent the confusion that derails many automation initiatives.
The governance structure shouldn't be static. Review and adjust it regularly as your program matures. What works when you're building your first five automations won't necessarily work when you're managing fifty.
Lesson 02: Get Staff Involved Early
Active staff participation makes or breaks automation projects. The people doing the work every day understand the nuances, exceptions, and edge cases that aren't obvious from process documentation.
When team members help select, design, build, and test automations, they develop ownership of the outcomes. They're invested in making things work rather than finding reasons why they won't.
Education matters here. Many staff members worry that automation will eliminate their jobs. Address this directly by explaining how automation handles repetitive tasks so they can focus on work that requires judgment and expertise. This isn't just reassurance—it's how successful programs actually function.
Well-educated staff also become your best source of automation ideas. They spot opportunities that leadership might never notice.
Lesson 03: Validate Use Cases Before Building
Not every good idea makes a good automation. Before committing development resources, validate that your use case will deliver meaningful value.
Start by identifying the total volume of transactions or accounts that qualify for the automation. It's common to discover exceptions that significantly reduce this volume. A process that seems to involve thousands of monthly transactions might only have a few hundred that actually meet automation criteria.
ROI typically comes from repetitive, high-volume processes where staff spend significant time. But don't overlook other value sources. Automation can accelerate revenue collection, reduce write-offs, and improve compliance. Factor these benefits into your evaluation.
The planning and validation phase feels slow when you're eager to build. Resist the temptation to skip it. Organizations that rush past this step end up with automations that cost more to maintain than they save.
Lesson 04: Test Like Your Program Depends on It
Automation errors erode confidence faster than almost anything else. When an automation creates problems that staff have to clean up, you'll hear about it—and people will question whether the technology is worth the trouble.
A strong testing process prevents this. For every automation you build, create a comprehensive testing plan that covers both expected scenarios and edge cases. What happens when data is missing? When formats are unexpected? When systems are slow?
Run tests with high volume before deployment. A handful of test cases won't reveal the issues that appear when processing thousands of accounts. Use production-representative data to ensure you're seeing what the automation will actually encounter.
Subject matter experts should conduct user acceptance testing and formally certify the automation for production. Their approval means the automation works as intended from an operational perspective, not just a technical one.
Lesson 05: Keep Stakeholders Engaged Throughout
Successful automation requires ongoing communication with stakeholders and experts—not just at the beginning and end of projects.
Maintain open communication. Connect with stakeholders regularly to stay informed about operational changes that might affect your automations. System updates, policy changes, and workflow modifications can break automations that were working perfectly. Regular updates, feedback sessions, and informal check-ins keep everyone aligned.
Prioritize change management. Automation changes how people work. Help staff understand the benefits, address concerns, and provide training on new workflows. Resistance often comes from uncertainty rather than opposition to improvement.
Learn from experience. After each project, assess what went well and what didn't. Document lessons learned and create improvement plans. This reflection takes time, but organizations that skip it repeat the same mistakes across projects.
Lesson 06: Plan for Ongoing Maintenance
Automations require regular attention to keep running smoothly. Organizations that treat automation as "set and forget" end up with systems that gradually degrade or fail unexpectedly.
Establish a ticketing system. Create a clear process for reporting and resolving issues. Work with IT during system upgrades to prevent compatibility problems. Monitor performance metrics to catch failures early.
Conduct quarterly audits. Review your automation processes regularly to identify glitches and inefficiencies. Quarterly audits balance the need for oversight with avoiding excessive micromanagement.
Document thoroughly. Detailed records of processes, updates, and operational requirements ensure continuity when team members change. Good documentation helps the automation team adapt quickly when something needs attention.
Lesson 07: Learn from Others Who've Done This
Community collaboration offers advantages that internal resources alone can't provide.
Other organizations have already solved many of the problems you'll encounter. They've tried different governance structures, validated similar use cases, and learned which approaches work. Learning from their experiences saves time and prevents mistakes.
Communities also help validate ideas before you invest resources. Peer feedback offers alternative perspectives and insights into efficient automation design. What seems like a great idea might have hidden complications that someone else has already discovered.
Beyond practical benefits, communities foster innovation. The cross-pollination of ideas from different organizations sparks creative solutions that wouldn't emerge in isolation.
Frequently Asked Questions
Q: What is an RCM automation program?
An internal initiative where healthcare organizations build and manage repetitive revenue cycle tasks like eligibility verification, claims status checks, and payment posting. These programs typically leverage robotic process automation and AI-enabled workflows to streamline manual touchpoints.
Q: What skills does an automation team need?
Technical RPA developers, agentic AI engineers, revenue cycle subject matter experts, project managers, and governance oversight from leadership.
Q: How do we prioritize which processes to automate first?
Focus on high-volume, repetitive tasks first.
