Dive Brief:
- A recent survey by Recondo Technology finds hospitals spend significantly more following up on late claims payments than most previous industry estimates.
- While former estimates have put the cost at an average of $3 per claim, the vast majority of survey respondents (70%) reported that their organizations actually pay $4 per claim.
- This 33% higher cost means claims follow-up could be costing healthcare providers $3.1 billion more than was previously believed, the report suggests.
Dive Insight:
Recondo reports claim follow-up is still typically done via manual, outdated approaches, despite the cost and the fact that exception-based technologies have the ability to streamline the process by eliminating claims from the work queue that are already scheduled to be paid.
It finds 53% of respondents reported their organizations using the 835 EDI claim payment transaction set to assist in automating follow-ups, 4% use the 277 EDI transaction set, 12% use web-sourced data pulled from payer websites, and 31% use none of those approaches.
"Not only is it costing the industry more than is currently believed to find problems within the healthcare revenue cycle and remediate them, but the vast majority of healthcare organizations are relying on outdated means to automate claims follow-up, outsourcing it, or doing nothing at all," said Jay Deady, CEO of Recondo, in a prepared statement. He suggests exception-based processing frees staff time for more important duties and saves money for the organization.