There are more than 5 billion medical claims filed each year in the United States . Of these, 30% are delayed or denied on first submission. Fifty percent of those denied claims (15% of total claims) are never resubmitted. The average cost to process a claim manually in a small medical office is $8 to $12. The average length of accounts receivable in most medical practices approaches 70 days. Number of times such errors may have resulted in due to inaccurate postings as a result the money realization is lower.

Monitoring internal billing efficiency is the first step toward maintaining sound financial health. Productivity is lowered when a staff faces challenges in getting access to proper patient, insurance, and billing information. For example, in some cases, each time the patient receives care, information must be entered in separate electronic and paper record systems.

The first key events in the health care billing process are: the DOS (date of service) and DOCE (date of charge entry). Financial managers need to check on the time lapsed between providing the service, entering the charge, and billing for it. At some organizations, services are entered into the accounting system only two or three times a month, creating a lapse of 8 to 10 days.

In many cases, Payors place time limits on claims. If it is not submitted within a certain time limit, it may not be paid. By upgrading accounting software and streamlining billing procedures, many organizations find they can reduce their DOS-DOCE time substantially. The greater the time delay between DOS and DOCE, the greater likelihood that information will be lost or inaccurate, creating a denial.

Payment postings are quite critical when it comes to realizing payments. As we work it, the agents analyze the payments and post them into the Hospital Information Management System. For partial payments, analysis is done and corrective action taken.