Physicians who let office staff handle denials process increase time they can spend with patients.

You’ve spent four years as an undergrad, another four in medical school and three to eight additional years completing a residency. That’s about 16 years honing your craft and paying your dues. You’ve chosen a path as a patient-care provider, not a billing specialist spending long hours staring at a monitor worrying about denials.

While evaluating, treating and caring for patients are arguably the most important part of any physician’s practice, countless hours are spent dealing with denied claims, which impedes providers and their staff.

But it turns out though that’s exactly what physicians around the world are doing: spending more and more time behind a screen rather than in front of patients. There is a way physicians can lessen their hands-on time spent with a computer and increase it with their patients.

Physicians who enable office staff to handle the entire denial appeals process increase the time they can spend with patients, improve productivity and boost revenue.

Time is (not) on My Side
A study published by the Annals of Internal Medicine found physicians spend a significant part of their day not treating patients, but instead completing other tasks. Throughout the day, these physicians spent approximately 27 percent of their time in face-to-face clinical contact with patients, according to the journal. Desk work and time spent working on the EHR (electronic health record) consumed approximately 49 percent. For the entire day, including evenings, physicians spent up to four hours on “desk work” for every one hour treating patients.

Another study, published in 2017 by the Annals of Internal Medicine of residents practicing at a Swiss hospital, found much the same when it came to the amount of time physicians treated patients and worked on a computer. In this study, physicians spent 1.7 hours with their patients and more than 5 hours doing computer work throughout the day.
While both studies were relatively small in sample size, physicians can easily infer from these numbers and their own experience that there’s less and less time available in the day to treat patients. And more and more time consumed and effort expended by physicians on tasks having nothing to do with their training. 

Help! I Need Somebody
While the studies don’t cite every back-office job physicians take on throughout the day, we’ve handled enough of them to know a significant number include denials management.
Denials are common—the Employee Benefits Security Administration reports 200 million claims are denied every year in the U.S.—and, for the most part, it’s a simple error causing the problem. But even simple errors can take hours to correct, making an automated appeals process critical to the long-term success of any practice.

Automatic for the People
An automated appeals process eliminates the need to inspect each payment individually and quickly resolves eligibility and authorization problems. This reduces the time physicians spend on the task themselves, and, importantly, allows the seamless hand-off of the job to office staff. Doing so improves overall practice efficiency and the physician’s own productivity.
The process uses payer rules to ensure office staff understand the reasons behind denials and identifies common errors. The best services look at current and retroactive denials to ensure the practice receives all the reimbursement it deserves, ensuring payment write-offs are a thing of the past.
Utilizing a robust claims denial methodology is critical to the long-term financial success of your practice because 50-65 percent of denied claims are never reworked, according to the Healthcare Business Management Association. Depending on the size of your practice and the number old claims never re-processed, you could be out tens of thousands of dollars.
When practices implement an integrated, automated denials management service, it gets physicians out of the office and back into the exam room where they belong and secures the payments physicians have earned and deserve.

If you’d like to find out how TriZetto Provider Solutions can help your practice perform better, please contact us at providersales@cognizant.com or 1.800.969.3666.

 

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We help physicians, hospitals and health systems simplify business processes and get accurate payments quickly. We will always look for new ways to help you improve revenue and increase cash flow. We will stay ahead of regulatory changes so your office will never struggle to keep up. All so you can focus on the one thing that really matters: doing what is best for your patients.

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