Manual business transactions costing healthcare billions
Monday, January 23, 2017
The move to digital record keeping has helped the healthcare industry reduce costs by improving efficiency. However, there's still a good deal of money to be saved with even more adoption of electronic business transactions in healthcare, according to the 2016 Council for Affordable Quality Healthcare (CAQH) Index.
How can we be sure? We can't really, but a good level of conjecture by the nonprofit organization suggests another $10 billion annually could be saved across the industry.
The widespread adoption of electronic business transactions is increasing, but the report says "resource-intensive manual transactions costs U.S. health plans and healthcare providers as much as $11 more per transaction and on average $6 more than when conducted electronically. Millions of these transactions are exchanged daily."
This is the CAQH's fourth annual report, which measures adoption, costs and provider labor time associated with the most common administration transactions conducted between health plans and providers.
Specifically, the CAQH findings attempt to point out that medical providers "could save at least 1.1 million labor hours per week" in transitioning completely to electronic transactions. Digging in, the study suggests physicians spend about eight minutes and up to a half-hour on manual tasks that include making phone calls, sending faxes and mailing correspondence — administrative work.
Patient insurance prior authorization creates a good deal of waste. If conducted electronically, physicians can possibly reduce the time per transaction from 20 to six minutes and the cost from $7.50 to $1.89.
The projected workarounds could be realized by automating some of the most redundant office tasks, like verifying a patient's insurance coverage, sending and receiving payment, inquiring about the status of a claim and obtaining prior authorization for care.
The projected savings grew by about $1 billion from a year ago because of including an additional transaction to the six that were previously measured.
"Claims attachments, the added transaction, are used to send extra information required for some healthcare claims, such as discharge summaries or operative reports," the report states. "Of note, 94 percent of claim attachments are currently submitted manually, which each cost nearly $6 more to process compared to electronic attachments. The collection of more precise data on cost savings for providers this year also contributed to the reported increase."
"Claim attachment solutions help practices reduce the cost of postage and fax charges, as well as administrative costs previously associated with manually managing claims attachments while enhancing data security," said Lindy Benton, president and CEO of Vyne. "They streamline the followup process on mailed claims; improve revenue cycle management; enable secure transmission of requested attachments; eliminate challenges associated with lost attachments that delay reimbursement; and decrease administrative time spent tracking claims and reimbursements."
The use of these electronic transactions rose by more than 5 percent, while the corresponding volume of manual verifications has not declined as rapidly with participating health plans fielding more than 72 million telephone inquiries in 2015.
"Dental and medical providers are making the move to automated claim attachment processes because they see tremendous value in the time saved for their teams and that equals improvements to their bottom lines," Benton added. "An added benefit well beyond the financial is the security provided by these electronic solutions over paper-based transactions."
Beyond medical savings and cost, the CAQH Index tracked for the second year the adoption of electronic transactions by dental health plans and providers, and for the first time the cost savings.Full electronic adoption of the transactions studied could save dental health plans nearly $500 million and dental providers more than $1 billion in labor costs.
The findings from the 2016 CAQH Index are based on voluntary nationwide surveys of providers, as well as commercial medical and dental health plans. Participating medical health plans represent more than 140 million covered and 5.4 billion transactions conducted in 2015. Participating dental health plans represent 112 million covered lives and 564 million transactions conducted in 2015.
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