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Exceptional Coders | Innovative Technology

The Rising Costs of Healthcare Billing

Posted by David Fong on May 8, 2018 6:00:00 AM

A recent study reported in a Los Angeles Times article found that healthcare in the United States is very expensive. One of the contributing reasons is that managing healthcare bills is really expensive. How expensive? At one large academic medical center, the cost of collecting payments for a single primary care doctor is upward of $99,000 a year.


RisingBillCostsResearchers from Duke University and Harvard Business School reconstructed the entire life cycle of a medical bill — from the time a patient makes an appointment until the time the health system receives the money for the services rendered. They applied their analysis to five types of "patient encounters."  The results were:

 

  • It cost $20.49 to get paid for a typical primary-care visit, and took 13 minutes of processing time.
  • It cost $61.54 to get paid for a typical trip to the emergency room, and took 32 minutes of processing time.
  • It cost $124.26 to get paid for a typical hospital stay, and took 73 minutes of processing time.
  • It cost $170.40 to get paid for a typical outpatient surgical procedure, and took 75 minutes of processing time.
  • It cost $215.10 to get paid for a hospitalization that required surgery, and took 100 minutes of processing time.

 

If those numbers aren’t enough -- in another study, Dr. Vivian S. Lee, a radiologist at the University of Utah, and Bonnie Blanchfield, a senior scientist and former CPA at Brigham and Women's Hospital in Boston, found that: "The unnecessarily complex, fragmented, and inefficient system of billing, coding, and claims negotiations in the US health care system employs enough people to populate a small nation.”

 

They concluded that there is no apparent reason for this. Outside the healthcare industry, it might take about 100 full-time workers to collect $1 billion worth of bills. But when doctors are involved, it takes "an astounding 770 full-time equivalents" to collect the same amount of money.  We couldn’t agree more that there is no reason for this.

 

Medical coding, which is a significant part of the billing process, can be outsourced to advanced medical coding companies, like Aviacode, that guarantee accuracy and turnaround; is less costly and is less hassle for practice managers, physicians, hospitals, and providers. Aviacode uses the best credentialed and experienced coders in the industry. All our coders are AAPC or AHIMA certified and have a minimum of years of experience, and they stay on top of changes in rules and compliance regulations.

 

In addition, coding denials add to the high cost of medical billing.  By coding and documenting correctly in pre-bill or minimizing coding denials, it can save the time and high costs to rebill.  Aviacode offers coding denial management services for a number of healthcare providers.

 

Aviacode has skilled coding expertise in a number of chart types, including inpatient, outpatient, same-day surgery, emergency department, observation, ancillary, recurring, and diagnostic and interventional radiology. Our coders and auditors have deep experience from facility, pro-fee, and HCC / risk adjustment.

By outsourcing their coding or coding denials, providers can save significant dollars, improve time for A/R collections, and impact their revenue stream.

Topics: Medical Coding, Clinical Documentation, Outsourcing, Coding Denial Management