Apr 18, 2011 – Delays in physician payments by health insurers add to the cost of healthcare. These delays can affect patient care as medical office staff spends time and effort managing administrative obstacles set by insurers. Payment delays can be limited by the creation of standard claim submission processes, and improved claim automation and integration.
The financial impact of payment delays to medical offices and medical billing service companies by insurers may improve as a result of recent proposals aimed at automating healthcare practices and administration through economic incentives provided by the federal government.
Wide variations in policies and procedures related to the submission of claims and payments by insurers, creates systematic confusion lending to inefficiencies in the system and higher costs for medical offices and physician billing services. Standardized policies and procedures would streamline claims submission and greatly benefit the system as a whole by reducing administrative red tape and healthcare costs, ultimately improving patient care.
Improved technology integration between the physician office and claims processing that truly automates work flows and prevents duplication of labor between the physician office, medical billing service and the health insurer’s claims adjudication process should be included in healthcare stimulus programs.
Additional healthcare savings could be provided with Health insurers staffing levels required to provide adequate staff to promptly provide claim assistance, follow up and feedback to physician offices. Healthcare facilities have a requirement to maintain adequate staffing to provide service to patients.
Provider manuals with up to date policies and procedures should be available from the health insurer. Provider manuals available online at the insurers’ website could be extremely helpful and a cost effective way of assuring information is always up to date for the physicians’ office.