How to Solve the Top 4 Challenges in Claim Status Inquiries

Posted by Andrew on October 7, 2019

Monitoring the status of a claim is important to ensure it funnels through the correct channels without time-consuming errors, denials, and more. However, providers often report that monitoring a claim’s status is a heavy burden as it takes up considerable time. While one claim only requires around 14 minutes and costs an estimated $7.12, medical providers made 737 million claim status inquiries by phone, fax, or partial electronic means in 2018 alone.

The following are the biggest hurdles for providers, practices, and billing teams when it comes to claim status inquiries:

  1. Manual inquiries are costly and time consuming. Looking at the statistics above, manual claim inquiries cost billions of dollars and took up millions of work hours.
  2. Claim status inquiries don’t yield actionable results. Many claims follow their course as they should, which means providers waste their time following up on claims that aren’t at risk of denial.
  3. There are often limits to how many inquiries a provider can place on one call. This means providers must make multiple inquiries, taking up even more time.
  4. Lack of visibility makes prioritization difficult. Providers can’t intrinsically know which claims offer the highest yield, which can mean they give unnecessary time and attention to lower priority claims.

The simplest way to shorten the amount of time and money spent on claim status inquiries is to automate the process. Compared to manual and partially electronic claims, fully autonomous claim status inquiries cost $1.89 per claim and only take up around five minutes of the provider’s time. This means with 100% electronic claim status inquiries, the healthcare industry could save as much as $2.6 billion per year.

Improving the claims process from start to finish not only improves customer satisfaction, but it also helps save time and money for the provider while boosting transaction rates for the insurer. Insurance companies will receive more claims on a faster timeline, which translates to more cash flow. To learn more about improving the claims handling process, contact the experts at Actec.