U.S. health plans and healthcare providers could save $9.4 billion by further transitioning from manual to electronic transactions, an average of $6 per transaction, according to a new study.
The report, by CAQH, (the non-profit Council for Affordable Quality Healthcare), found providers could also save at least 1.1 million labor hours per week with the transition. They now spend 8 minutes on average on manual tasks, including making phone calls, sending faxes and mailing correspondence.
The fourth annual CAQH Index measured adoption, costs and, for the first time, provider labor time associated with the most common administrative transactions conducted between health plans and providers. These include verifying a patient’s insurance coverage, sending and receiving payment, inquiring about the status of a claim and obtaining prior authorization for care.
The study found that prior authorization offers providers the greatest time savings potential if conducted electronically, reducing the time per transaction from 20 to 6 minutes and the cost from $7.50 to $1.89.
Julie Vayer, vice president for Cigna’s total health and network operations, said her company participated in the survey and is committed to the efficient exchange of administrative healthcare data.
“By working together to standardize the way health plans process transactions, and by identifying industry best practices, we can help create a fully electronic healthcare system that will benefit consumers, providers and payers,” Vayer said.
To encourage greater adoption of electronic business transactions, the report proposes that the industry share best practices, conduct targeted industry-led efforts to reduce adoption barriers and perform systemic reviews of current standards, codes, operating rules and policies.
“When we can reduce the amount of paperwork for our physicians and staff, more time and resources can be spent caring for patients,” said Joseph D’Allaird, Director of Revenue Cycle at Cortland Regional Medical Center, a data contributor to the 2016 CAQH Index from Cortland Regional Medical Center.
The findings from the 2016 CAQH Index are based on voluntary nationwide surveys of providers, as well as commercial medical and dental health plans.
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