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American Medical Association Calls for Efficient Claims Handling

By Julia Subscribe to RSS | January 26th 2012 | Views:

Healthcare businesses, like other companies, continually strive to increase operational efficiencies to make the operation more productive and boost the bottom line. Claims handling is one key area where such improvements can be made, particularly from moving from paper processes to digital systems that reduce human error.

Why Claims Handling Should Change

A November 2011 article on entitled “Efficient Claims Handling: A Gift that Keeps on Giving” focused on how electronic insurance claims can increase efficiencies, thereby saving purveyors time, frustration, and costs. It stated that much of the improvements, however, must come from the health insurance industry in which “insurers ??? bunglebungle claims, leading to wasted time and money for practices that must sort out the errors. In some cases, payers are inaccurately handling more than a third of the claims they receive from doctors.”

However, physicians and medical practice managers can play an important role in adding efficiency to the process, namely by adopting electronic claims systems and standards. Paper processes cause various problems, including the following:

Too much time is spent trying to respond to insurance eligibility questions.

Payments for services take longer to receive.

A lot of time is spent to fix any mistakes or human errors.

The result is higher expenses and lessened service performance. On the other hand, electronic processes solve most – if not, all – of these issues. While it is not the end-all or cure-all, electronic claims handling seems to deliver a higher level of efficiency.

AMA Offers Assistance

The article acknowledges that physicians and medical practices need information, assistance, and encouragement to migrate, so the American Medical Association (AMA) is offering advice, tool kits, and webinars. For instance, they have an online Practice Management Center to provide help and guidance. The article noted that “many physicians have realized its promise and have shared their success stories through the Heal the Claims Process campaign for a practice to dismiss the possibility without careful consideration.”

Help is Available

While the AMA provides guidance, many smaller offices or medical practices with tight budgets face challenges in adopting these electronic practices in-house, including an initial upfront expenditure for software, equipment, and training. An alternative route is to partner with an outsource provider that specializes in electronic medical claims handling and understands key aspects of the medical industry that impact this process. This will best assure you’re employing the expertise and systems to process your claims in the most efficient and effective manner possible.

Julia - About Author:
The above article is taken from the blog of One Source Doc regarding claims handling

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