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BLOG: So You’re Submitting Your Claims Electronically… What About Your Attachments?

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It is rare that we come across a medical office or facility that is still submitting their medical claims manually on paper to the insurance companies. Most are submitting their claims electronically because it is easier, cheaper and exceedingly more efficient than mailing or faxing their claims. Many insurance companies encourage their providers to submit claims and additional documentation electronically because it is also easier, cheaper and more efficient for them to process provider paperwork electronically. On average it costs a payor $6.63 to manually process a paper claim, whereas an electronic claim costs a payor $2.90 to process; a saving of $3.73 per claim. The savings on the provider level are equally impressive because they are able to eliminate faxing/mailing, paper and additional administrative costs associated with paper claims submissions. However, even with all of these savings, it is rare that we come across a provider that is also submitting their claim attachment’s electronically. Instead, providers are dropping all claims that require attachments to paper and are faxing/mailing the claim with the paper attachment. This leaves room for lost attachments, delays in payor processing and slower reimbursement cycles. Electronic attachments enable providers to fully automate their claim submission process by allowing them to submit all claim substantiation documentation electronically, eliminating the need to manually submit paper documentation. Payor’s also benefit from accepting electronic attachments because the majority of their claims and attachments are received electronically, thereby greatly reducing their processing costs. Consider this: in 2010 there were 12,871,500,000 medical claims filed in the U.S.* and 10-30% of those claims required attachments; that’s 1,287,150,000– 3,861,450,000 attachments. If all of those claims and attachments were submitted manually, it cost payors $4,801,069,500-$14,403,208,500 more to process those paper claims and attachments. Plus, the average medical provider can spend $7,000-$21,000 annually filing paper claims and attachments**. Even though many do not consider attachments to be a costly endeavor for payors or providers, the figures above should change their mind. Removing paper from the claims and attachment process has proven to increase efficiency thus dramatically reducing all costs associated with the claims process.

*U.S. Healthcare Efficiency Index 2010

*Based on the average provider filing 6,200 paper claims annually @ a cost of 11.29 per claim/attachment with 10-30% of the claims requiring an attachment. Gathered paper claim costs data from Milliman “Electronic Transaction Savings Opportunities For Physician Practices” white paper