Streamlining health insurance reimbursement is important not just for patients, but also for the medical billing department whose job it is to maximize revenue and minimize cost per processed claim. Unfortunately, it can all too often take months for insurance companies to process paper medical claims. However, with the new era of electronic claims, some insurers are now able to process claims within a week of receipt. One key to shortening health insurance reimbursement cycles is to include electronic attachments in the claims process.
Considering that much of patient information is already included in electronic charting and electronic patient medical records, a system that supports sending that information to insurers along with the rest of a claim is the next logical step. We already know that processing a claim manually costs nearly three times as much as dealing with the same claim in digital format, and so having all of the relevant claim documentation available digitally allows for even more automation. Experience has shown that an electronic attachment solution results in faster reimbursement, reduced overhead, and improved client service.
Even though attachments are only applicable in a portion of medical claims, they can have a significant impact on the speed of health insurance reimbursement. Consider the time it takes providers to print supporting documentation for an unsolicited attachment, prepare it, and mail or fax it, and then the time it takes payors to open, index, sort, and enter it into their adjudication system. Further delays are seen when payors delay claims and mail out EOBs or request for information to providers, otherwise known as solicited attachments. These solicited attachments are often requested two to four weeks after the initial claim submission. Adding attachments digitally to the electronic submission process shortens this cycle, which results in quicker health insurance reimbursement. MEA’s clients have reported reducing their outstanding receivables by 10 to 14 days, a proven way to save time and save money in the claim filing process.
Insurance reviewers are overloaded by the amount of paper that they can wade through in a day, which in turn limits the number of claims that they can process. Any increased efficiency in the review pipeline can up the number of claims processed without an increase in staff. Electronic documentation via attachments tends to result in fewer denials and rework requests as well, since the most typical cause for these delays is a failure to provide required documents. These time savings mean more claims processed per day, and thus quicker overall health insurance reimbursement.
Both providers and payors will welcome an increase in efficiency, as will the patients who see the results. Electronic attachments are just one way that technology is improving healthcare business processes, and there may well be new technologies just around the corner to streamline even further.