{"id":6536,"date":"2016-08-02T10:49:18","date_gmt":"2016-08-02T10:49:18","guid":{"rendered":"http:\/\/www.medicalbillersandcoders.com\/blog\/?p=6536"},"modified":"2025-05-24T13:29:06","modified_gmt":"2025-05-24T13:29:06","slug":"mind-boggling-medical-billing-facts","status":"publish","type":"post","link":"https:\/\/www.medicalbillersandcoders.com\/blog\/mind-boggling-medical-billing-facts\/","title":{"rendered":"Mind Boggling Medical Billing facts"},"content":{"rendered":"<p style=\"text-align: justify;\">It\u2019s all about Billing, Billing, Billing \u2013 Ringing in the cash revenues!<\/p>\n<p style=\"text-align: justify;\">Here are some mind-boggling Medical Billing facts that affect healthcare revenues impacting the Revenue Cycle Management Process and medical billing practices.<\/p>\n<p style=\"text-align: justify;\">The total market size of outsourced <a href=\"https:\/\/www.medicalbillersandcoders.com\/revenue-management-services.aspx\">revenue cycle management (RCM) services<\/a> has already reached $5 billion, and it is estimated that escalating financial pressures will further expand the market<\/p>\n<p style=\"text-align: justify;\">The average US doctor spends one-sixth or 16.6 percent of his or her working hours on administrative tasks alone and includes billing rechecks<\/p>\n<p style=\"text-align: justify;\">It is estimated that doctors in the U.S. leave approximately $125 billion on the table each year due to poor billing practices.<\/p>\n<p style=\"text-align: justify;\">And that about 25 to 30 percent of lost medical practice income is due to improper billing.<\/p>\n<p style=\"text-align: justify;\"><b>Did you know that it takes as many as 250 people- from the nurse to the medical coder \u2014 who could be involved in generating just one bill!!<\/b><\/p>\n<p style=\"text-align: justify;\">And despite the technology and processes and workflows, some experts opine that as many as 80 percent of the medical billing contains errors!<\/p>\n<p style=\"text-align: justify;\">And a recent survey conducted in the United State revealed that the single largest yet avoidable reason for about 78.2percent of all Insurance Claim Denials is because of &#8211;<i> incorrect patient demographic<\/i> <i>information<\/i>.<\/p>\n<p style=\"text-align: justify;\">Added to this, approximately 30 percent of all claims submitted to an insurance carrier on the initial submission are denied whether they are correct or not. Insurances workers do this because only less than 25 percent of medical practices appeal their claims denial in the USA!!<\/p>\n<p style=\"text-align: left;\"><strong>30 percent of the 15 billion claims submitted annually in the US are denied<\/strong><\/p>\n<ul style=\"text-align: left;\">\n<li>Of the aforementioned 30percent, 15 (675 million!) are never resubmitted<\/li>\n<\/ul>\n<p style=\"text-align: left;\"><strong>Medicare denies about 11percent of all claims submitted<\/strong><\/p>\n<ul style=\"text-align: justify;\">\n<li style=\"text-align: left;\">Of the aforementioned 11percent, 40 percent are never resubmitted<\/li>\n<\/ul>\n<p style=\"text-align: justify;\"><b>But, there is always a light at the end of the tunnel<\/b><\/p>\n<ul style=\"text-align: justify;\">\n<li style=\"text-align: left;\">According to CMS data, 65percent of the claims carriers reviewed on appeal resulted in an increased payment to the provider<\/li>\n<li style=\"text-align: left;\">70-80 percent of all appealed claims eventually get paid<\/li>\n<\/ul>\n<p style=\"text-align: justify;\">Did you know that over $5.6 billion in health information breaches cost the healthcare industry annually<\/p>\n<p style=\"text-align: left;\"><strong>Benefits of Partnering with a trusted <a href=\"http:\/\/www.medicalbillersandcoders.com\">medical billing partner<\/a> have experienced an improvement in the following key performance metrics:<\/strong><\/p>\n<ul style=\"text-align: justify;\">\n<li style=\"text-align: left;\">73 percent of organizations realized a reduction in A\/R days and achieved higher collections.<\/li>\n<li style=\"text-align: left;\">59 percent observed a reduction in the number of denied claims.<\/li>\n<li style=\"text-align: left;\">59 percent of firms reported access to better reporting and analytical tools<\/li>\n<\/ul>\n<h2 style=\"text-align: left;\">Top 7 Reasons Healthcare Firms Outsource RCM (PricewaterhouseCoopers)<\/h2>\n<p style=\"text-align: left;\">1. Lower costs \u2013 76 percent<\/p>\n<p style=\"text-align: left;\">2. Gain access to talent \u2013 70 percent<\/p>\n<p style=\"text-align: left;\">3. Outsource activities that others can do better \u2013 63 percent<\/p>\n<p style=\"text-align: left;\">4. Increase business model flexibility \u2013 56 percent<\/p>\n<p style=\"text-align: left;\">5. Improving customer relationships \u2013 42 percent<\/p>\n<p style=\"text-align: left;\">6. Offering new services to the customers\/market segment expansion \u2013 37 percent<\/p>\n<p style=\"text-align: left;\">7. Geographic expansion \u2013 33 percent<\/p>\n<h3 style=\"text-align: left;\">Billing Practices<\/h3>\n<p style=\"text-align: justify;\">Physicians can charge almost $20 for a simple pen used to mark a patient\u2019s skin for surgery to\u00a0 a 500 percent markup for a single over-the-counter pain reliever (and each subsequent pill dispensed)<\/p>\n<p style=\"text-align: justify;\"><i>Two doctors who ran a mental health facility billed Medicare for an enormous sum of money. These physicians had been billing for therapy that was never performed. Medicare paid these doctors for the intensive outpatient treatment they were supposed to be administering. Over a period of five years, these doctors managed to bill Medicare for $97 million dollars before being brought up on charges.<\/i><\/p>\n<p style=\"text-align: justify;\">Despite all the scams &amp; fraud, the\u00a0<a href=\"http:\/\/www.bls.gov\/ooh\/office-and-administrative-support\/financial-clerks.htm#tab-6\">Bureau of Labor Statistics<\/a>\u00a0expects employment of all billing clerks to increase by 11 percent from 2012 to 2022, which is about average growth.<\/p>\n<p style=\"text-align: justify;\">Demand for certified medical billers may even outpace that for billing clerks in other industries, due largely to the aging U.S. population and the fact that the elderly access the healthcare system more frequently than other age groups.<\/p>\n<p style=\"text-align: justify;\">Many institutions are looking to strengthen their financial management arms \u2013 28 hospitals and health systems\u00a0posted job listings seeking RCM expertise for their organizations in July 2016 itself!<\/p>\n<p style=\"text-align: justify;\">May the cash registers jingle all the way\u2026<\/p>\n","protected":false},"excerpt":{"rendered":"<p>It\u2019s all about Billing, Billing, Billing \u2013 Ringing in the cash revenues! Here are some mind-boggling Medical Billing facts that affect healthcare revenues impacting the Revenue Cycle Management Process and medical billing practices. The total market size of outsourced revenue cycle management (RCM) services has already reached $5 billion, and it is estimated that escalating [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":12576,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[900,746,80,747,30,359,778,737,738,46,47,751,198,15,417,162,9,11,64,339,146,192,753,754,418,144,815,816,699,86,205,904,58,34,27,785,789,905],"class_list":["post-6536","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medical-billing-services","tag-account-receivable","tag-billing-services-for-doctors","tag-cpt-codes","tag-cpthcpcs","tag-credentialing","tag-dme-billing-services","tag-dmepos","tag-e-m-codes","tag-e-m-services","tag-ehr","tag-emr-ehr-health-it","tag-hcpcs-code","tag-hospital-billing","tag-medical-billing","tag-medical-billing-agencies","tag-medical-billing-and-coding-services","tag-medical-billing-companies","tag-medical-billing-outsourcing","tag-medical-billing-practices","tag-medical-coding-audits","tag-medicare-2","tag-medicare-medicaid-services","tag-medicare-billing","tag-modifier","tag-online-medical-billing","tag-outsource-medical-billing","tag-outsourced-medical-billing-company","tag-outsourced-medical-billing-services","tag-outsourcing-primary-care-billing","tag-physician-billing","tag-physician-bundle-payment","tag-prior-authorization","tag-rcm","tag-reimbursement","tag-revenue-cycle-management-2","tag-telehealth","tag-telehealth-services","tag-telemedicine"],"yoast_head":"<!-- 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