Question

Use the following link (also provided under the resource tab) to see the 100 healthcare statistics. (Links to an external site.)Links to an external site. Becker Hospital Review claims a healthcare professional should know. This is an article from 2014, while the actual statistic may have changed; the statistical topic is as relevant as the day the list was published.

Once you have reviewed the list, choose three of the statistics to use as a reflection for your initial discussion post. Please do not forget to include the updated statistic you found during your research. It would be interesting to see if there is a significant difference and what caused the change to occur. A reminder, a reflection is what did I learn, what does this mean to me, or how does it relate to an aspect of my life as a future HIM professional.

Answer 1

Most of the united states facing unexpected medical bills and having problem for their health care payment..Americans aged from 18 to 64 years struggling to pay medical bills in the past few years..most of the americans are uninsured,,patients mostly confused with their medical bills when it come from mails and posts..claim denails are the major source of revenue loss for hospitals..payers deny 9% hospital claims, $5million in payment per hospital at risk..
claim management work flow related to the revenue cycle once the patient visit by the doctor..claim management process of translating service make billable charges,make clinical codes to price, due to inadequate clinical documentation there is inaccurate capture and revenue leakage, organization face with charge capture issues hospitals and health care organization need focus on the submission of quality clean claims that to be done in the first place..statistics make best to avoid revenue leakage associated with denied claims..due to this payers are confused with claims..
As per Becker's articles CMS statistics:
numbers of claims paid first time they submitted 70%
number of claims that are denied or lost 30%
number of claims that are never resubmitted from this 30% is 60%(medicare and medicaid reimbursement is lost forever)
Medical billing department should make a standard procedures to work on denied claims daily..claim rejection and denial make much problem due to errors in the revenue cycles..Technology used to avoid this issues, making single system to manage the revenue cycle can processed a good management revenues and help identify the revenue leakage whenever happens..
In 2016 change health care analysis $262billion of the estimated, $3 billion in claims by hospitals last year initially denied as per new analysis by change health care..There are changes health care found the pacific region 10.89%,midwest 10.32% and south central 10.5%..there are many reasons for this denial due to registration error followed by missing or invalid claim data..