As you probably know, the whole process of filing insurance claims is cumbersome, time consuming and energy-draining. The insurance companies have made it as difficult as possible to get paid; they obviously have a vested interest in paying out as little money as they possibly can. One of the best ways they've found to hang on to their money a little longer is that they've created this extremely difficult set of hoops that doctors have to jump through to file and collect their insurance claims.
The energy-draining process is probably all too familiar to you already. First, you have got to spend an average of 10 to 15 minutes filling out the CMS 1500's. That could take hours a day if you have very many patients. Then, if there is any minute detail on that paperwork that's not filled out exactly correct, the insurance company rejects the entire claim and sends it back to you-unpaid. So then you have to figure out what the problem is, attempt to fix it, and then re-submit it and hope you have gotten it right the second time around.
The results of this frustrating process are startling: A whopping 32% of claims are rejected, 5 to 15% are lost in the shuffle and NEVER collected, and the average time it takes the doctors to collect their money is 60 to 90 days. and it can be even longer for Medicaid claims.
Then, besides stretching the time it takes to receive payment, this process also presents you with another major problem: It takes a tremendous amount of employee and overhead cost for you to mess with this whole claims filing process. In fact, the New England Journal of Medicine says that a doctor's overhead and billing expenses account for 43.7% of his gross income. That translates into an average of about one and a half clerical workers per doctor at an average cost of $51,564...not including hidden costs like vacation time, insurance, and the like. |
