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Industry Overview

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Industry Overview

  • An increase in revenue opportunities
  • An acceleration in rate of collections
  • Shorter revenue cycles
  • An overall achievement in significant cost savings

Challenges faced by practices

  • Incomplete, inaccurate, or "dirty" claims account for more than one in four submitted by physician offices
  • Major reasons of revenue losses in billing
    • Insurance Eligibility
    • Denials in Electronic Data Interchange
    • Inefficient or no follow up of claims filed
    • Unauthorized write offs by staff
    • Improper and late processing of claims denied by payers
    • Inefficient patient collection system
  • Over 16.3 billion dollars are wasted annually in the processing of flawed claims

Problems faced by health care service providers

  • High staff turnover
  • High training costs to meet compliance standards
  • Legacy, ineffectual and complex business processes
  • Cash flow variations due to errors, long turnaround times and quality
  • Time restraints for Management functions