• Skip to main content
  • Skip to secondary menu
  • Skip to primary sidebar
  • Skip to secondary sidebar
  • Skip to footer

  • Opinion
  • Health IT
    • Behavioral Health
    • Care Coordination
    • EMR/EHR
    • Interoperability
    • Patient Engagement
    • Population Health Management
    • Revenue Cycle Management
    • Social Determinants of Health
  • Digital Health
    • AI
    • Blockchain
    • Precision Medicine
    • Telehealth
    • Wearables
  • Startups
  • M&A
  • Value-based Care
    • Accountable Care (ACOs)
    • Medicare Advantage
  • Life Sciences
  • Research

Survey: Hospital Cost of Following-up on Late Insurance Claims Higher Than Estimated

by Fred Pennic 01/07/2016 Leave a Comment

  • LinkedIn
  • Twitter
  • Facebook
  • Email
  • Print

Survey: Hospital Cost of Following-up on Late Insurance Claims Higher Than Estimated

The cost of following-up on late insurance claims is significantly higher than most industry estimates, according to new survey from Recondo Technology. The survey reveals that despite the availability of exception-based processing to automate the resource-intensive claim follow-up process, most hospitals rely on legacy outsourced or employed manual approaches that have generally failed to lower costs.

Survey Background

Recondo surveyed 80 healthcare finance professionals from hospitals, physician groups and consultant organizations in November 2015 during a Recondo-sponsored Healthcare Financial Management Association (HFMA). Respondents provided a high-level view of the current state of medical claims follow-up – the process by which hospitals and physician groups query insurers about the disposition of bills submitted for patient services. Claim follow-up is traditionally done over the phone by back-office staff, who can review no more three or four claims at a time, depending on the payer’s rules. 

Key Findings

Various industry estimates have pegged the cost of this time-consuming manual process at between $2.75 and $3.25 per claim.  However, 70 percent of survey respondents said the actual cost for their organizations is $4 per claim, 33 percent higher than the average $3 estimate. The difference is significant. The nation’s healthcare providers submit an estimated 3.1 billion claims annually, meaning claims follow-up could be costing them $3.1 billion more than is commonly believed. 
 
Even with costs that high, though, survey respondents indicated their organizations are making poor use of exception-based technologies that can streamline claim follow-up by removing claims from the work queue that are already scheduled to be paid.
 
Over half (53 percent) of respondents said their organization uses manual follow-up efforts directed by the 835 EDI claim payment transaction set to help automate claims follow-up, even though the technology is widely viewed as lacking timeliness and specificity. The remaining respondents use either the 277 EDI transaction set (4 percent); web-sourced data pulled from payer websites (12 percent); or none of these approaches (31 percent). 
“Not only is it costing the industry more than is currently believed to find problems within the healthcare revenue cycle and remediate them, but the vast majority of healthcare organizations are relying on outdated means to automate claims follow-up, outsourcing it, or doing nothing at all,” said Jay Deady, CEO of Recondo in a statement. “By contrast, exception-based processing that uses web-sourced data can immediately remove over half of soon-to-be-paid claims from the work queue, freeing up staff for more important duties and saving money for the organization.”  
  • LinkedIn
  • Twitter
  • Facebook
  • Email
  • Print

Tagged With: Recondo Technology.

Tap Native

Get in-depth healthcare technology analysis and commentary delivered straight to your email weekly

Reader Interactions

Primary Sidebar

Subscribe to HIT Consultant

Latest insightful articles delivered straight to your inbox weekly.

Submit a Tip or Pitch

Featured Insights

2025 EMR Software Pricing Guide

2025 EMR Software Pricing Guide

Featured Interview

Paradigm Shift in Diabetes Care with Studio Clinics: Q&A with Reach7 Founder Chun Yong

Most-Read

Medtronic to Separate Diabetes Business into New Standalone Company

Medtronic to Separate Diabetes Business into New Standalone Company

White House, IBM Partner to Fight COVID-19 Using Supercomputers

HHS Sets Pricing Targets for Trump’s EO on Most-Favored-Nation Drug Pricing

23andMe to Mine Genetic Data for Drug Discovery

Regeneron to Acquire Key 23andMe Assets for $256M, Pledges Continuity of Consumer Genome Services

CureIS Healthcare Sues Epic: Alleges Anti-Competitive Practices & Trade Secret Theft

The Evolving Role of Physician Advisors: Bridging the Gap Between Clinicians and Administrators

The Evolving Physician Advisor: From UM to Value-Based Care & AI

UnitedHealth Group Names Stephen Hemsley CEO as Andrew Witty Steps Down

UnitedHealth CEO Andrew Witty Steps Down, Stephen Hemsley Returns as CEO

Omada Health Files for IPO

Omada Health Files for IPO

Blue Cross Blue Shield of Massachusetts Launches "CloseKnit" Virtual-First Primary Care Option

Blue Cross Blue Shield of Massachusetts Launches “CloseKnit” Virtual-First Primary Care Option

Osteoboost Launches First FDA-Cleared Prescription Wearable Nationwide to Combat Low Bone Density

Osteoboost Launches First FDA-Cleared Prescription Wearable Nationwide to Combat Low Bone Density

2019 MedTech Breakthrough Award Category Winners Announced

MedTech Breakthrough Announces 2025 MedTech Breakthrough Award Winners

Secondary Sidebar

Footer

Company

  • About Us
  • Advertise with Us
  • Reprints and Permissions
  • Submit An Op-Ed
  • Contact
  • Subscribe

Editorial Coverage

  • Opinion
  • Health IT
    • Care Coordination
    • EMR/EHR
    • Interoperability
    • Population Health Management
    • Revenue Cycle Management
  • Digital Health
    • Artificial Intelligence
    • Blockchain Tech
    • Precision Medicine
    • Telehealth
    • Wearables
  • Startups
  • Value-Based Care
    • Accountable Care
    • Medicare Advantage

Connect

Subscribe to HIT Consultant Media

Latest insightful articles delivered straight to your inbox weekly

Copyright © 2025. HIT Consultant Media. All Rights Reserved. Privacy Policy |