Manual Administrative Tasks The Negative

Recent studies have shown that by the year 2020, the United States might reach almost 20% of our gross domestic product (the total monetary value of all final goods and services produced and sold on the market typically within a year), making us the largest healthcare spender of any nation in the world. The expanded Medicaid and private insurance coverage are expected to increase demand for health care significantly, particularly for prescription drugs and physician and clinical services.

Continuous growth in Medicare enrollment, expanded Medicaid coverage, and premium and cost-sharing subsidies for exchange plans are projected to increase the federal government share of health spending from 27 percent in 2009 to 31 percent by 2020.

While our healthcare atmosphere continues to grow, so will manual administrative tasks between providers and pays, which will likely slow down healthcare all together. Common payer-provider enrollment transactions such as Electronic Funds Transfer (EFT), Electronic Remittance Advice (ERA), Electronic Data Interchange for Claims (EDI), Claims Status Inquiry (CSI), and Eligibility Verification (EV) are necessary to help healthcare organizations get paid efficiently for their services, and for payers to manage provider data.

However, even with “electronic” in the name, nearly half of ERAs are performed using some amount of manual process.

What goes into completing a form you ask:

  1. Find & read the enrollment rules
  2. Correctly fill out the enrollment forms
  3. Manually submit such forms.
  4. Re-Check the enrollment status
  5. Start back at #1 and repeat these steps

This repetitive manual process is eating up time and money spent trying to receive payments, not including dealing with denials, missing documents, and delayed payments. Studies have shown that providers lose 1.1 million labor hours A WEEK; time that could be spent with their patients. Physician burnout is becoming a larger issue these days. As burnout rates keep increasing, this leads to potential for more money lost.