ICD-10: 2016 Mid-Year Report
Good news on the ICD-10 front, the data continues to reveal a decrease in claims processing and payment times.
At the mid-year mark, our data is reflecting a steady decrease in claims processing and payment velocity. Reviewing average processing time from January 2016 through mid-June 2016, we are noting that:
- Average staff processing time has shown a steady decrease during the year, with average staff processing time in January of 17 days to an average of 8 days in May.
- Average payer processing time has decreased throughout the year, with an average of 15 days in January to 12 days in May.
- Total claims processing time was reduced by nearly 60%, with total processing time of 32 days in January to 12 days in June.
Payment velocity data also reveals excellent news for providers: as of June, our data is reflecting that on average nearly 80% of all claims are being paid within 30 days.
However, denial rates are holding relatively steady. June denial rates are 1% less than January.
It’s important to note that claims are still rolling in, especially for May and June, so the numbers may vary, though we don’t expect any major changes. As we move closer to October 2016, when the expected grace period for specificity on ICD-10 codes ends, will the data show huge shifts? Or, will we see the data continue to stay steady?
We will continue to monitor the data as October approaches. Stay tuned.
ICD-10 Update – Read all about it in ADVANCE
What’s the real story with the ICD-10 rollout?
We took a snapshot of the data over the past six months (Oct. 1, 2015 – March 31, 2016) and compared to the same six-month period from a year ago (Oct. 1, 2014 – March 31, 2015). What we found was that overall, all continues to be quiet with no major issues on the ICD-10 front. But the story that isn’t being told is that denial rates and processing times are down, and claims are getting out the door faster – which we would chalk up to being an overall improvement post-ICD-10.
Check out our results in today’s ADVANCE online.
Healthcare Costs Are Still Rising. Let’s Figure Out Why.
We are halfway into 2016, and the U.S. healthcare expenditure estimates continue to climb beyond $3 trillion. That’s trillion with a “t.” How many zeros is that?
In our relentless journey as an industry to solve this growing number, we did our own investigating to see what we could learn. So, we listened again to some insightful information from our own Brad Hill in a podcast recorded at this year’s HIMSS conference.
To set the stage, the podcast opens with this very question: “Why are healthcare expenditures in the U.S. so astronomical, especially compared to other industries?”
Brad began his conversation with some interesting insights, one of which includes the fact that this is the only industry where consumers actually accept paying for services without the ability to shop around, compare costs and make informed financial decisions. With health being such an important component of our lives, healthcare costs can vary up to 400% between providers! That makes the revenue cycle process all kinds of complicated for everyone.
This was only one small point Brad made in this interview. Have a quick listen to the full podcast and let us know what YOU think, and let’s keep working to figure out how we can help drive change.
Is Your State Making Patients Pay More Out of Pocket?
Every quarter, we have made it a mission to review the data that flows through
our solutions to reveal the latest insights around revenue cycle management for healthcare organizations.
In Q1, we did a study on the average amounts, by state, that patients are paying out of pocket for services. Interestingly enough, this information can help the way you modify processes within the revenue cycle and how you evaluate your processes for collecting patient funds.
For instance, did you know that 72.4% of the time a routine venipuncture lab test has one of the highest out of pocket costs for patients?
Check out all our findings in this infographic featured on Physicians Practice.
Revenue Cycle Services: Put your data to work for you and your clients
It’s no surprise that more ambulatory practices are outsourcing their billing and collection processes due to complex regulations and changing payment models that make it more difficult than ever to get paid. Read the complete white paper.
Improve cash flow and business performance by tracking, measuring and managing key operational and financial measures. Identify and address factors driving claim denials, reimbursement payment delays, and other issues affecting your bottom line with analytics and peer-to-peer benchmarking.
TITAN is a single source of transparency that allows you to view client performance. With one tool you can have a centralized view of all client accounts and can accurately assess the health of those businesses. You can also offer your clients increased transparency into how you are managing the health of their businesses.
Drive revenue cycle, workflow and operational performance improvements via our subscription service that leverages data mining, practice analytics and peer comparisons. Use the service to gain insights into the revenue cycles of your prospects and land new business.
Streamline the denial management and reconciliation process while reducing the cost of collections with our SaaS-based solution that includes analytics, management reports, workflow solutions, on-demand EOBs and benchmarking.
Reduce time spent on document management with a SaaS-based platform and OCR technology to identify, index, file and retrieve EOBs, patient records, clinical notes and other documents.
Save time and improve productivity with electronic filing and retrieval capabilities for both paper and electronic EOBs. Search for and retrieve specific information by patient or batch criteria.
Based on recent ICD-10 data from our ICD-10 Resource Center, Carl Natale, Editor of ICD10 Watch shares some fascinating insights on the current trends we’re seeing with denial rates! And, it’s pretty interesting information.
We frequently share this kind of data that Carl has written about with our subscribers, share your information below and stay informed about the latest data analysis trends for healthcare denials!
Leveraging Comparative Analytics
Helping payers control healthcare costs through greater transparency
By Brad Hill, Vice President of Payer Solutions, RemitDATA
Payers who believe big data provides all the answers they need to establish competitive pricing are only getting half the picture. Comparative analytics take big data to a new level, allowing payers to achieve reduced costs by providing pricing transparency.
Many organizations believe they already have an analytics solution. However, the missing piece is often the comparative component. Comparative analytics offer the ability to help lower the medical cost of care, enhance member engagement and reduce administrative costs. As a result, payers have the data they need to help reduce their medical cost of healthcare by enabling their members to compare pricing in the ever-changing healthcare services market-delivering information that patients otherwise would not have.
Click here to read more.