Revenue Cycle Management is a Top Challenge for Healthcare Practices

Data is our business. Well, it’s the focal point of our business. We believe data, whether primary research focused, aggregated or anecdotal helps any business make empowered business decisions.

Naturally, we look to data to inform our own business, which is why the survey we conducted among providers, RCM companies and healthcare vendors was so beneficial.

From that survey, we were able to aggregate and report some key findings on the four biggest concerns among healthcare organizations. For example, nearly half of providers (41 percent) cited acquiring new patients and competition as a top concern. More than 50 percent of RCM companies and vendors reported acquiring new customers as a top challenge.

Want to know more? Becker’s Hospital CFO published an article on these key findings from our survey. To learn more, click here.

NEW Claim Level Detail Reports in TITAN

It is a common practice among health plans to review claim level detail when working with 835 data. Providers can now get this same level of information straight from the 835 file, and get a complete view of claim level detail and related adjudication information.

We are proud to announce that this new capability is now available in TITAN!

Here is the low down:

Currently in TITAN, all metrics are based on service line detail. With the addition of claim level detail, you now have access to more metrics along with the service line information you have become accustom to monitoring.

New Reports Based on 835 Metrics include: 

  • Average Claim Processing Time Analysis: Analyze claim counts vs. service line counts to track patterns and reveal issuesClaim Average Processing Time Analysis
  • Claim Denial Analysis – Identify and track denial trends at the claim levelClaim Denial AnalysisClaim Denail Analysis 2
  • Claim Dollar Overview – Determine which payers have the highest or lowest billed amount per claimClaim Dollar Review

These new claim level reports give you access to the following features.

  • New filters including: claim status and claim filing indicator
  • New query logic, such as claim status, enables more clarity and insights
  • Expanded comparative capabilities via 835 database
  • Review overall claim volume and/or dollar totalsReview Your Overall Totals
  • Analyze claim status breakdown by payer
    Analyze a breakdown by Payer
  • View a report of service claim details with service line detailsSee Claim Level Details from the 835 combined with the service line details

If you are a TITAN user, we encourage you to contact us with any questions you might have.

If you are not currently using TITAN, click here so we can show you how healthcare comparative data could help improve your revenue cycle.

RemitDATA’s New Knowledge Center: Tools to Help Solve Your Business Challenges

As a medical practice, chances are you’ve experienced spikes in certain claim denials with very little insight into the root cause. Right?

As a billing company, perhaps your clients need you to pull reimbursement tracking information TODAY, but your systems can’t pull it quickly enough to satisfy. Been there?

And Payers, is it possible that quick data insights might help you better control costs more accurately during the pre-authorization phase – so you have the wherewithal to inform in network surgeons about the huge cost variances within their contracted facilities – redirect surgeons and help your members  lower costs, at high quality locations?

From managing claim denials to navigating the Affordable Care Act, payers, providers, and billing companies alike need help navigating the healthcare ecosystem to ensure a healthy bottom line.

RemitDATA is responding to your needs with information and news you can use. Our new Knowledge Center gives you access to case studies, videos, white papers, webinars, podcasts and more. Access these resources  to better understand how your peers are solving some of their business challenges and how you can do the same.

You’ll find:

  • Use cases from current TITAN users, who share their challenges and solutions to help save time, reduce frustration and improve business operations.
  • Best practices and tips through white papers, webinars, podcasts, and videos.
  • Valuable insights and data from RemitDATA experts.
  • And other critical information.

For access, visit

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.

 Processing Time ICD-10 June Blog

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.

Remittance Velocity ICD-10 Blog June

However, denial rates are holding relatively steady. June denial rates are 1% less than January.

Denial Rate ICD-10 Blog June

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.

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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.

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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 RemitDATA_Physicians_practice_May 2016
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.

ICD-10 Healthcare Comparative Analytics - Request more info