As we continue our journey post-ICD-10 conversion, while it’s important to note that it’s still early in the game with many claims still outstanding, we are starting to see some change in claims processing times.

According to our data, the national average for staff processing time is 15 days, and 11 days for payer processing time, which echoes the industry buzz. There is also talk about the difficulties coders are experiencing getting claims out the door as they adjust to the thousands of new codes associated with ICD-10.

Taking a state-by-state look at processing time, approximately 1/5 of the country is meeting the national average for processing time, with a nearly even split among those states taking longer to process vs. processing faster. Our data is revealing that approximately:

  • 18 states are taking longer than the national average of 15 days to process claims
  • 10 states are on par with the national average
  • 22 states are processing claims faster than the national average

As we examine denial rates, we are beginning to see an upward tick in denials between mid-January 2016 and mid-February 2016, as follows:


With respect to payment velocity, we also are beginning to see payments slowing down, per category, as follows:


With a few changes in data this month, it will be interesting to see what March data reveals, stay tuned for additional information next month.


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