BC Advantage - 2008 Issue 12

Rethinking claims editing

Loss of revenue due to preventable claim rejection is a persistent industry problem with a disproportionately negative impact on cash flow. Just considering the hard dollars - and not issues like staff productivity and overhead - medical practices and their billing services are leaving quite a bit of money on the table. Even today, rejection rates of ten percent are common. And rates as high as 40 percent are not unusual. With delays due to appeal and re-submission, cash flow suffers and coding and billing staffs spend many hours re-working claims. The concept of using claims editing software or...

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