When an individual decides to enter the medical profession, there are numerous reasons to do so. Many are obvious ones, such as compassion and a desire to serve, a passion and curiosity for learning, medicine, and science, and other cases, even a family tradition. It is doubtful that anyone practicing medicine goes into it for the paperwork! Unfortunately, most of that paperwork ultimately represents revenue to pay staff, expenses, and make a life. That paperwork also represents some of the $812 billion spent on administration in 2017 by health insurers and providers.1 A bit more recently (2019), it was estimated that $496 billion is spent on just the billing and insurance-related (BIR) costs, according to the Center for American Progress.2 As noted in JAMA, an article cited N.R. Sahni, et al. which, “estimated that administrative spending was $950 billion in 2019, of which 94% was in five functional focus areas: financial transactions ecosystem, industry-agnostic corporate functions, industry-specific operational functions, customer and patient services, and administrative clinical support functions.”3,4 Of course, some of these items will be present regardless of any streamlining. Patient scheduling and HR are and will be crucial for both care and administration, irrespective of any reform. Nevertheless, there hasn’t been a shortage of proposals to lessen these numbers – nor should there be – and one of the most fertile areas for improvement is the financial transactions ecosystem.
Advantum Health is acutely aware of the need for enhancement within revenue cycle management and is leading the initiative to advance provider payments to a truly frictionless process.
One way is by investing in our staff ensuring that their training stays ahead of any upcoming changes to regulations – and that they have strong preparation prior to “going live”. That commitment to training, along with job satisfaction, empowers our employees to make the best and most knowledgeable decisions for our clients.
Another enhancement has occurred from investing in technology. Advantum has been working behind the scenes with infrastructural improvements designed to lessen errors, delays, and costs to our clients.
Between these dual initiatives of technical and human resources, Advantum Health is committed to lessening the burden on providers’ financial transaction ecosystems with a powerful, more accurate, and economically sustainable revenue cycle management system. These translate to lower denial rates, along with higher reimbursement, and “first pass” resolve rates.
References
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G. Kahn, “Excess Administrative Costs,” in P.L. Young, R.S. Saunders, and L. Olsen, eds., The Healthcare Imperative: Lowering Costs and Improving Out- comes: Workshop Series Summary (Washington: National Academies Press, 2010), available at https://www.ncbi. nlm.nih.gov/books/NBK53942/.
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https://cdn.americanprogress.org/content/uploads/2019/04/03105330/Admin-Costs-brief.pdf
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Chernew and H. Mintz, Administrative Expenses in the US Health Care System: Why So High?JAMA, 326(17), 1679 (2021). doi:10.1001/jama.2021.17318
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N.R. Sahni, P. Mishra, B. Carrus, D.M. Cutler, Administrative Simplification: How to Save a Quarter-Trillion Dollars in US Healthcare (McKinsey & Company 2021). https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/administrative-simplification-how-to-save-a-quarter-trillion-dollars-in-US-healthcare