Monday, November 27, 2006
Survey Finds Electronic Medical Claims and Billing Can Save Health Care Costs, Reduce Billing Errors
A study released by The PNC Financial Services Group, Inc., found that the health care industry's reliance on paper to file and pay medical claims contributes to the high cost of health care, and industry-wide adoption of electronic claims remittance processing could improve efficiency, cut costs and reduce medical billing errors.
Pittsburgh, PA (PRWEB via PR Web Direct) April 3, 2006 -- A study released by The PNC Financial Services Group, Inc. (NYSE: PNC), found that the health care industry's reliance on paper to file and pay medical claims contributes to the high cost of health care, and industry-wide adoption of electronic claims remittance processing could improve efficiency, cut costs and reduce medical billing errors.
The survey of executives from U.S. hospitals, health systems and insurance companies further
found that hospitals and health plans have the capability to file, process and pay medical claims electronically, but lack of standards continues to be a barrier to automation despite evidence that improved efficiency would eliminate extraneous costs and alleviate the hassles patients experience when covered claims are lost or denied.
“As consumers shoulder more of the cost of their own health care and demand greater transparency of pricing, market forces may make automated, electronic medical claims remittance processing a business imperative and competitive advantage,” said Paula Fryland, manager of PNC’s national health care group.
PNC conducted the e-Health survey to benchmark the current state of electronic claims remittance processing in the private health system, and to identify barriers to and opportunities for industry-wide adoption. Highlights of the findings include:
o 90 percent of hospital executives and 86 percent of insurance executives agreed that making the claims remittance process more efficient industry-wide would help slow the rising cost of health care.
o 85 percent of hospitals and 74 percent of insurance executives agree that the nation’s healthcare costs would actually decrease if health plans were required to publicly report the efficiency/performance of their claims filing and billing processes.
o 83 percent of insurance company executives agree that health plans should have to disclose information about the payment processes in the context of how these costs ultimately affect healthcare premiums.
o Half of hospital executives and four out of 10 insurance executives said their organizations could save at least $1 million and as much as $10 million a year if their billing and payment processes were more efficient.
o These savings could be used to improve patient care, according to 90 percent of hospital executives surveyed. Seventy-five percent said they would pass these savings directly to patients and two-thirds would use savings to provide care to more of the uninsured.
The majority of hospital and health plan executives surveyed said they consider their organization’s current billing and payment process to be highly efficient, yet the study showed there is significant room for improvement.
o On average, hospitals must submit a medical claim four times before it is paid in full. Health plans said they have to go back to providers. on average, six times to get additional information to pay a claim. Five percent of all insurance-covered medical claims are never paid.
o Nine in ten executives surveyed said they still use regular mail to send and receive claims and remittance information. Paper-based, back-up information is heavily relied on by both hospitals and health plans, particularly for payment and remittance advice.
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