Top 5 Mistakes in Claims Management – And How to Avoid Them
Claims management accuracy and efficiency are crucial for hospital billing, accounting and finance professionals. However, common missteps can cause...
Last year, over half of healthcare providers reported an increase in denied claims within their organizations. Common reasons cited included registration errors, inadequate documentation and inaccurate or missing patient information.
As the volume of denied claims continues to escalate – average denial write-off rates are now almost four times what they were in 2018, leaders are increasingly focused on identifying optimal solutions to address these challenges.
One of those organizations was the University of Washington Medical Center (UWMC), which sought to decrease its claim denials rate and streamline internal claims processes to maintain financial health and ensure optimal patient care.
About the University of Washington Medical Center
With more than 5,500 employees, UWMC has been the No. 1 hospital in Seattle and state of Washington since 2012, according to U.S. News & World Report. UWMC boasts one of the largest medical research programs in the world and is committed to delivering exceptional, multidisciplinary care to its patients.
The Challenge
Like many healthcare organizations, UWMC experienced a high volume of rejected claims, which were negatively impacting its bottom line. A known fact is claims are rejected for a variety of reasons, including eligibility errors, demographic errors, missed filing deadlines, prior authorizations and more.
According to the American Medical Association, the cost of reworking a denied claim can range from $25-$118 per claim, and providers spend an average of 20-60 minutes on each one, which can drive up labor costs.
Plus, cash collection was ineffective for UWMC, and without good visibility into claims data, a stronger bottom line was tough to achieve.
The Solution
To improve their claims management process, UWMC turned to FinThrive to get claims right the first time they were submitted.
FinThrive’s Claims Manager helped UWMC streamline its claim process by eliminating vendor redundancy and manual work as well by integrating with the organization’s patient accounting systems.
Within FinThrive’s Claims Manager, UWMC has been able to:
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Generate the claim
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Edit and validate the claim
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Submit the claim via clearinghouse
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Track claim status
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Track payments
RELATED: 5 Top Questions to Evaluate a Claims Management Solution
The Results
After implementing FinThrive’s Claims Manager, UWMC experienced significant improvement related to denied claims, including:
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Denied claims rate dropped more than 50%
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Clean claims rate improved from 84% to 92%
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Average days from claim to export dropped by 33%
Interested in implementing a claims management solution at your organization? Check out our Claims Management Buyer’s Guide to help ensure you find the right platform to meet your needs.
