Inefficiency costs a lot. In fact, The Health Imperative: Lowering Costs and Improving Outcomes report published by the Institute of Medicine estimates time spent on unnecessary administrative tasks, such as making phone calls to pharmacies, manually verifying patient insurance coverage and resubmitting denied claims costs the average small practice around $314,953 a year.
Even though standards such as HIPAA 5010 have helped boost efficiency, there is still a significant opportunity for practices to save valuable time and money, especially now that ACA Operating Rules are in place.
These guidelines, which require payers to use the same remittance and remark codes, send consistent benefit information and standardize EFT and ERA enrollment, give practices critical information they need to streamline operations.
With access to the right data in the right format, providers can eliminate time-consuming phone calls, improve revenue cycle management accuracy and optimize reimbursement. For example, through automating the eligibility verification processes, practices can expect 25 percent fewer rejections than those using manual processes.* In addition, a CORE/CAQH-IBM Study found that practices experienced 10-12 percent fewer denials when automated eligibility processes were in place.
If your practice hasn’t fully automated processes such as eligibility, now is the time. By doing so, you’ll not only have the deductible, co-pay and co-insurance information you need to collect a patient’s financial responsibility at the time of service, but you will also be able to significantly reduce denials, a benefit that’s well worth the investment.
*Based on Navicure Client Analysis, 2013