Administrative costs in the U.S. health care system consume an estimated $361 billion annually—14 percent of all health care expenditures in our nation. At least half of this spending is estimated to be wasteful.1 In an era of government budget deficits and rising health care costs, the case for reducing the administrative complexity of health care is compelling. Successful efforts can result in significant financial savings while simultaneously improving system performance indicators and the quality of patient care. [Read More]
The American Medical Association (AMA) strongly supports the provisions in the Patient Protection Act and Affordable Care Act (ACA) that are designed to streamline the claims management revenue cycle. The AMA is committed to eliminating administrative waste in the health care delivery system. Cost estimates of inefficient health care claims processing, payment and reconciliation are between $21 and $210 billion. In the physician practice, the claims management revenue cycle consumes an unsustainable 10-14 percent of practice revenue. [Read More]
Few words arouse more frustration among primary care physicians (PCPs) than “prior authorization.” And it’s easy to understand why. The time you and your staff have to spend persuading an insurance company to cover a medication or procedure is an expensive and annoying distraction from the task of caring for patients.
On the bright side, while you may not be able to avoid prior authorizations entirely, you can take steps to minimize the hassle and expense they bring. [Read More]
A physician who currently relies on paper and telephone calls for insurance administration may be able to save more than $42,000 a year through simple steps to increase electronic transactions for operations like claims submission, referral and preauthorization requests, and eligibility verification. These are savings that go right to the bottom line. [Read More]
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