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How Many weeks in a Year do you end up spending on Health Insurer Red Tape?

January 20, 2014

While much is said about the Patient Protection and Affordable Care Act (PPACA), it is known that it has not been able to adequately address the impact on doctors, patients, and the practice of medicine. Due to this, more doctors have preferred switching over to a “cash only” system to combat the impacts of red tape procedure of healthcare insurers.

Industry Facts State:

As much as $ 210 billion per year is spent by the health care system on claims processing
Approximately five weeks of physician’s time annually is spent on health insurer red tape

Excessive regulation and rigid conformity to redundant/bureaucratic formal rules of insurance companies hinders decision-making actions of physicians causing substantial time delay. According to an independent survey, the United States spend most on insurance administrative cost, $606 per person, compared to $277 in France and $266 in Switzerland, the next-highest countries. The report also suggests that this high administrative spending in the United States is the directly related to the country's complex, more fragmented health insurance system.

Impact of healthcare insurer red tape on your practice:

Complicated billing practices and administrative systems result in grossly inefficient communication between physicians, hospitals and insurers and lead to higher-cost care for patients. Physicians’ offices spend large amounts of administrative time on getting paid for the care they provide. In most of the cases, billing and insurance-related costs account for more than half of all administrative spending, impacting total office revenues.

As a result of red tape, the insurers also share the burden of inefficient administrative processes, around one-fifth of insurer's spending goes to billing and insurance-related costs instead of direct patient care.

Streamlining your billing can help reduce healthcare Ccsts:

We all know that our current healthcare system is fragmented. Healthcare costs are rising faster than inflation and wages, forcing doctors and hospitals to spend more time and money on administrative support than is necessary, which ultimately leads to increase in healthcare costs and impacts your revenue. However, by streamlining key processes — such as insurance billing and payment and physician credentialing at hospitals — you can collectively save hundreds of millions of dollars annually and lower the cost of your healthcare.

By streamlining your health care administrative practices, you can help fix your broken healthcare system and save consumers money. This could be accomplished by:

  • Formation of a health information network:This network can be operated on a non-profit basis, and funded and governed by participating health care entities. This network can be established in parallel with the adoption of further technology-related health care reforms.
  • Arrangement of short-term, low-interest loans to needy parties: While most healthy businesses will be able to make the small investments necessary to operate the health information network, forming a network to help finance the investments of struggling parties by granting small, low-interest loans can help boost the revenue at your practice.
  • Implementation of complementary health care reforms: The efficiencies gained through a health information service can help related health care policies. A standard set to spend a minimum percentage of revenues on car can incentivize participation in an information network leading to reduction in overhead costs in the long run.

Integrated health information networks can help healthcare providers and payers increase efficiency and cut costs by:

  • Empowering public-private partnership to operate a computerized system, which can also serve as common intermediary between providers and insurers.
  • Creating the network that functions as an information pipeline for embracing federal regulations and achieving administrative simplification.

Optimize your time management using MBC’s complete billing solutions:

As a physician, you can avoid the extra expenses and combat the red tape effect without investing your valuable time with the help of a billing specialist like MBC. We constantly aims to find ways to increase accuracy, efficiency and visibility for you with our claims analysis and management process.

Complete Data Analysis To verify accuracy of diagnosis and procedure codes to ensure compliance
Charge Overview To identify loopholes in procedures documented and check for misplaced and missed charges
Regular Reports To identify claim resubmission and claim status to enhance payment transparency and ensure better control over payments
In-depth Process Study To identify claims with codes that might not support the medical necessity
Documentation Improvement To address deficiencies not covered by the clinical and coding professionals
Expert Team Monitoring To track your claims throughout the claim’s pay cycle and providing regular audits

All these actions help reduce the red tape impact and increase your practice efficiency and revenue.


MBC the largest consortium of billers and coders has been providing medical billing services for over a decade now; meeting necessary requirements for medical necessity and claims stipulations. Our team is constantly working to identify opportunities which help improve accuracy, compliance and productivity in a multi-payer health care system. MBC provides medical billing service across all 50 US States in varied specialties; which meets national and local requirements for medical necessity and complies with commercial claims stipulations.

MBC = Cost reduction + Timely processing = Complete Satisfaction

Category : ACA / HIPAA / Reforms