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Volumn 29, Issue 6, 2010, Pages 1248-1254

Saving billions of dollars - And physicians' time - By streamlining billing practices

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CLINICAL PRACTICE; COST CONTROL; HEALTH CARE COST; HEALTH SERVICE; HOSPITAL BILLING; MEDICAL FEE; PHYSICIAN; WORKING TIME; ACCOUNTING; ECONOMICS; FINANCIAL MANAGEMENT; HEALTH CARE POLICY; HEALTH INSURANCE; MEDICARE; METHODOLOGY; ORGANIZATION AND MANAGEMENT; REIMBURSEMENT; UNITED STATES;

EID: 77956926894     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2009.0075     Document Type: Article
Times cited : (25)

References (24)
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    • For example, the following factors all increase the complexity of processing payments: the changing and increasing need for processing referrals and the implementation of internal and external systems to streamline their issuance; the increasing number of diagnosis and procedure codes; prior authorization for medically necessary services; heterogeneous credentialing requirements; differing payment rules between payers in one health care market; opaque and elusive payment rules; the lack of uniform billing and administrative denial and adjudication processes; and the "arms race" between physician organizations and insurers in creating infrastructure to deal with these phenomena
    • For example, the following factors all increase the complexity of processing payments: the changing and increasing need for processing referrals and the implementation of internal and external systems to streamline their issuance; the increasing number of diagnosis and procedure codes; prior authorization for medically necessary services; heterogeneous credentialing requirements; differing payment rules between payers in one health care market; opaque and elusive payment rules; the lack of uniform billing and administrative denial and adjudication processes; and the "arms race" between physician organizations and insurers in creating infrastructure to deal with these phenomena.
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    • These projections include all administrative costs, taxes, profits, and other nonbenefit expenses of private health plans. Administrative costs related to billing are just one component of these costs
    • These projections include all administrative costs, taxes, profits, and other nonbenefit expenses of private health plans. Administrative costs related to billing are just one component of these costs.
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    • A more detailed methods discussion is included in the Appendix, which is available by clicking on the Appendix link in the box to the right of the article online
    • A more detailed methods discussion is included in the Appendix, which is available by clicking on the Appendix link in the box to the right of the article online.
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* 이 정보는 Elsevier사의 SCOPUS DB에서 KISTI가 분석하여 추출한 것입니다.