Health Care Providers Can Resolve Denied Insurance Claims Faster, to Reduce the Cost of Collection
INDIANAPOLIS–(BUSINESS WIRE)–RealMed announces the addition of a denial management tool that helps physician practices resolve their denied insurance claims more quickly, resulting in better cash flow for the practice.
Reducing the cost to collect on unpaid medical claims is a significant financial challenge for physician practices, where the average practice may experience a claim denial rate of greater than 10 percent, with more than 60 percent of those denials ultimately being written off due to their difficulty to collect.
Physician practices now have the ability to analyze claim denials using detailed reports, so they can more quickly initiate process changes to close gaps in time-to-payment. Using RealMed’s enhanced real-time reporting and on-demand explanations of benefits, physician practices can determine if denials are payer-specific, biller-specific, coding errors, or part of a pattern — and can take action.
According to RemitDATA, the company whose processing enables the new RealMed tool, physician practices can expect to reduce denial rates to three to four percent, a level associated with best practices as described in the 2011 MGMA study of performance and practices of successful medical groups.
“Providing health care management solutions that enable real transparency into our customers’ claims, billing and collection processes translate into significant cost advantages that include lowering denial rates, being paid faster and improving staff productivity,” says Scott Herbst, senior vice president of provider solutions at RealMed. “By including RealMed’s denial management tool among our portfolio of offerings, we can continue to support our customers’ growing need to improve financial and operational process efficiencies.”
Physician practices can benchmark their business performance against peers, which is especially important as evolving payment models and new coding practices are changing the landscape for physician reimbursement. Armed with information about how their denial rates compare with similarly sized competitors in the same specialty, providers can adjust workflows and automate rework to become more efficient.
“Strategic insight to denial patterns can create a distinct financial advantage for physician practices,” said Sean Kilpatrick, director of the provider portfolio for RealMed. “Simply put, denial management tools can help health care businesses run better — and in this era of emerging new payment models and continuously changing regulatory mandates such as ICD-10 and ANSI 5010, physician practices need every advantage they can get.”
RealMed, an Availity company, is a national leader in revenue cycle management solutions for the health care industry. RealMed solutions connect physicians, practice management systems and health plans with essential real-time business information to drive staff productivity and facilitate better patient experiences. For more information, visit www.realmed.com or call 877-RealMed.