Administrative complexity is a billion-dollar problem, full of human-led, handmade steps that simply don’t need to exist.
In a given year, approximately a quarter to a third of our health expenditure comes from the waste of the whole system. Sometimes the cause of money wastage is obvious, such as duplicate testing, misdiagnosis, prolonged stays in the ER, overtreatment, or failures in care coordination. The least obvious collaborator: time.
Time is wasted on almost every step of the healthcare process, from patient billing to payer reimbursement, and affects everyone involved: patients, providers, payers, compensation centers, and everyone in between. . We all know that time is precious, time is cash, and until all parties can move from manual to automated, the health administration’s status quo suggests that the industry is comfortable with wasting both.
The cost of the supplier’s time
Unnecessarily complex administrative transactions have a direct impact at the vendor level. The healthcare business is still very manual and fragmented. The time it takes manual labor to achieve even the most basic transactions at the goal contributes about $ 350 billion to the annual costs of health administration.
How long are we talking about here? Even before the Covid-19 pandemic, enrollment transactions took weeks and months to complete: a massive delay for providers waiting for payments for the ongoing care they are providing. In addition, on average, medical providers spend eight more minutes perform manual transactions compared to electronic transactions. And switch to fully electronic transactions could save suppliers nearly $ 30 for an encounter with a single patient.
This is a hard pill to swallow because if health systems could reduce transaction time, more time and money could be spent on higher value activities that generate ROI.
The cost of partners time
Providers are essential and make the healthcare system work, but when it comes to transactions, they have their hands tied. Providers have very limited time to move away from patient care and often work with partners for these tasks. Ideally, the role of the supplier in each transaction should be automated and fast to avoid slowing down. Revenue Cycle Management (RCM) and compensation partners. The role of the couple should be the same.
There are about 4,000 payers in the U.S., each with their own forms, standards, requirements, and portals used for vendor transactions. Unfortunately, what most partners experience is a very manual process: downloading forms, tracking vendor information, rewriting the same information on different forms, faxing, sending emails, uploading, and requesting status checks.
Doing this job by hand is inefficient, it is much less likely to be error free and a way of doing business that should be a relic of the past. Downloading these tasks to technology can be done in days, not weeks or months like now.
The cost of payer’s time
Time also affects payer costs. Directory maintenance is essential in healthcare to help patients and their caregivers find and build the right healthcare team, but most of the time, these directories are obsolete. In a study, the researchers found that Google generated more accurate information about physicians than directories of health plan providers.
There are too many hoops to skip just to change a phone number or address – regular updates with the increasing mergers and mobility of doctors. Payers require vendors to update directory details in a specific way, which can cost vendors $ 1,000 a month. He reason for this cost? “A constant flow of requests, at different times, using different technologies and in inconsistent formats.” In other words, time.
Not to mention, in any type of transaction with payers (from electronic payments to communication to credentials), a lot of data and information about suppliers changes hands. This is often done on paper sent 84% of the time via email or a fax machine, instead of emails or portals. Ultimately, payers feel the same way, as old information contributes to patients bouncing in and out of the network.
From recovered hours to improving an organization’s results, there is no need to rehearse the benefits of automation. We all know them. We just have to use them.
It is time for a single front
It has been said before that innovation is about taking two things that already exist and uniting them in a new way. When all the right people and systems are aligned, innovation can become the industry standard.
To address what affects healthcare administration, payers, providers, and partners need to move from manual to automated together. This shared commitment is the most efficient and effective way to address the time lost in administrative functions and how it greatly affects overall health costs.
The solution is clear and before our faces. The key is to automate every step of the healthcare administration processes: data collection from providers, collection of forms by payers, data population, data management from the provider, all in all. We have the solution at our fingertips.
About Eric Demers
Eric Demers is the CEO of Health of Madaket, direct the platform which is the neutral center and the only true source for the exchange of data from the provider. Eric has a keen eye for applying technological solutions to ancestral health care problems to help create efficiency and scale.