The healthcare industry is not just a highly competitive segment but also employs some of the most complex procedures and follow up services. Right from fixing the appointment of the patient till the closure of the file, a lot of procedures, planning and inventory is involved in every stage and that is what makes outsourcing a great option. Health care businesses involves a lot of overheads and manpower in dealing with some of the most time sensitive and critical activities like medical billing services, payment, collections and insurance verification. Handling health care business activities demands a lot of experience and accuracy to handle these tasks in a time bound and the most accurate manner.
Here are some of the challenges faced by the health care businesses, which prompt them to consider the idea of outsourcing.
22% Claims are Rejected
Reports suggest that on an average 22% of medical insurance claims submitted were rejected and 40% of these claims were never resubmitted due to paucity of time or late processing among various other factors. Often the payer do not make payment due to faulty claims with wrong address or demographic data of the beneficiary or lack of supporting data. When a medical claim is rejected, it makes a time consuming process to do the necessary follow up and appeal to get the payment. In some cases, the concerned personnel are not aware of how to go about the process or have a lackadaisical attitude.
Non-Core Medical Activities take up 14% of healthcare expenses
Out of the annual healthcare budget of $2.7 trillion in the USA, a staggering $400 billion goes to non core expenses like claims processing, medical billing and Payments among others. This happens due to outdated procedures and manual transaction that involves a lot of overheads.
10% Claims are wrong
The American Medical Association study reports say that 10% of claims are not paid on time because they are either incorrect or incomplete. In some cases commercial payers underpay on claims, which will further increase the revenue loss. High error rate and wrong entries account to a loss of around US$ 17 billion each year for health care businesses.
The above facts and figures will show how important it is to ensure correct medical billing services for health care businesses. This is where outsourcing assumes a greater signifi