Medical claims processing behaviour – Pilot case study

Introduction to medical claims processing behaviour study

Through a pilot program of 42 practices that exhibited low Send Now medical claims processing behaviour patterns, we set out to prove that the setup and processes of a practice can change behaviour. Through an in-depth audit, the practice were adapted accordingly to allow claims to be sent while the patient was still at the practice and the behaviour that followed was monitored for a 4 week period.

Results

Overall, the Send Now medical claims processing habits of the practices changed significantly and this behaviour remained ongoing across the majority of participants. In particular, one of our most impressive practices who adopted the entire process of Send Now, together with the collection process, achieved around 66% reduction in his book debt. Interestingly the trend of Send Now behaviour was consistent across all provinces and all specialities including Dentists, Specialists, Optometrists and Auxiliary practitioners.

Conclusion

As the study revealed, medical claims processing sending behaviour can be changed by changing a practices process and set-up.

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