Why are some insurance payers slow to pay claims?
Just like any other business, the longer insurance companies keep the providers’ money in their own banks, the higher the interest earned on that money. Higher interest means greater dividends for stockholders each month, and this keeps the investors happy. Consequently, it is in the best interest of insurance payers to deny or delay claims as often as possible.
Why do insurance companies respond to outsource agencies?
Insurance companies are concerned about upsetting customers who pay premiums and who expect their claims to be paid in a timely manner. Angering enough customers due to slow claims processing and referral to outsource agencies can cause insurance payers to lose customers and their monthly premiums. In addition, insurance companies are concerned about their own credit ratings and reputations in the industry; therefore there is some incentive for them to pay claims quickly enough to avoid any public relations issues.
The Cost of Denials and Delayed Insurance Payments
Denied and delayed claims are costing U.S. hospitals billions each year. This has resulted in some facilities facing cash-flow issues and also has had a negative impact on overall reimbursement and revenue generation. Less money coming in to a health care system often affects the services that can be offered to patients and the caliber of equipment that can be provided to physicians for medical treatment.
Working unpaid claims is taking an increasing toll on healthcare employees tasked with following up and trying to collect all dollars owed by payers. The time spent reviewing coding, providing medical records, contacting payer representatives, auditing charges and meeting other payer demands is extremely time consuming for hospital staff. This increases the cost to collect on each account thereby decreasing the real worth of each insurance payment.
More staff is often needed to handle the higher volume of insurance follow up needed, yet decreased or slower reimbursement leaves many hospitals unable to afford to hire additional staff. As a result, an increasing number of healthcare providers find themselves in a quandary while they bleed insurance money due to untimely filing or lack of follow up.
Hollis Cobb Offers Solutions
Hollis Cobb currently provides insurance filing and follow up services for health care facilities nationwide. Our clients’ internal analyses have shown that we are exceeding client goals for processing of claims, speed of reimbursements and low error rates. All insurance claims are processed in our Account Resolution Department (ARD), where our skilled staff has many years’ experience in claims verification, filing, follow up, denials management and appeals. We work as an extension of our clients’ insurance departments providing a transparent and professional service to the patients. Each client has a team dedicated solely to their book of business.
Throughout our 40 year history, we have evolved to meet the ever-changing needs and demands of the healthcare arena. Our years of experience and dedication to clients has created a verifiable track record of success in revenue cycle management, particularly in the area of insurance accounts resolution. Hollis Cobb has stayed on the leading edge of the revenue cycle management industry, ensuring that our technology, compliance, quality assurance and philosophy are in sync with what healthcare providers are seeking in a partner.
