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 un...more
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 th...more
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.more
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 B...more
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.more
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!
Here we are, six months into the ICD-10 conversion.
While the headlines continue to trumpet “all is quiet” what is the real story?
We thought it would be interesting to take a look at this six-month period and compare it to a year ago. Below is a snapshot of our data for the last six months (Oct. 1, 2015 – March 31, 2016), which we compared to the same six-month period from the previous year (Oct. 1, 2014 – March 31, 2015) – the results are quite interesting:
- By Type of Service Level I, denial rates appear to be down slightly.
- Processing times are down.
- And claims appear to be getting paid faster.
What we can conclude is that yes – 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.
What remains to be seen is how those may or may not change in October 2016, when the grace period ends. Stay tuned!