Comments on: Administrative Costs Bringing Health Care Down http://www.nuesoft.com/blog/administrative-costs-bringing-health-care-down/ Just another WordPress site Mon, 09 Jan 2012 14:11:08 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: Sherri Dumford http://www.nuesoft.com/blog/administrative-costs-bringing-health-care-down/#comment-6455 Sherri Dumford Wed, 26 Aug 2009 20:00:37 +0000 http://www.nuesoft.com/blog/?p=65#comment-6455 I read with interest the items listed as the top $ wasters in our health care system and was not surprised that processing claims was in the top two. In fact, I'd probably argue it really is number one. I'm not certain of the metrics used to determine what constitutes "overtesting", but I doubt unless we change our litigious culture that physicians will rest easy in reducing the number of tests. The delivery and management of more reliable and efficient patient care through the use of technology could avert unnecessary procedures and/or avoid mistakes. Administrative simplification; however, is an area that could have a dramatic impact on healthcare expenditures. HIPAA and standardization was supposed to help achieve simplification and thus reduce costs. It should go without saying that allowing insurers to have companion guides requiring the "billing chain" to operate with standards in addition to the standards cost software companies, billing companies and ultimately the provider and patient. Requiring the use of standard denial and remark codes; eliminating the long wait time for provider enrollment and simplifying the appeals process are areas where significant improvement in the cost of providing and get paid for healthcare could be improved. Require the insurance industry to be compliant with the standards!! I read with interest the items listed as the top $ wasters in our health care system and was not surprised that processing claims was in the top two. In fact, I’d probably argue it really is number one. I’m not certain of the metrics used to determine what constitutes “overtesting”, but I doubt unless we change our litigious culture that physicians will rest easy in reducing the number of tests. The delivery and management of more reliable and efficient patient care through the use of technology could avert unnecessary procedures and/or avoid mistakes.

Administrative simplification; however, is an area that could have a dramatic impact on healthcare expenditures. HIPAA and standardization was supposed to help achieve simplification and thus reduce costs. It should go without saying that allowing insurers to have companion guides requiring the “billing chain” to operate with standards in addition to the standards cost software companies, billing companies and ultimately the provider and patient. Requiring the use of standard denial and remark codes; eliminating the long wait time for provider enrollment and simplifying the appeals process are areas where significant improvement in the cost of providing and get paid for healthcare could be improved. Require the insurance industry to be compliant with the standards!!

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