OptumInsight (formerly Ingenix) and Dallas-based RemitDATA have together launched Remit Advice Professional, a Web-based service that offers physician practices access to intelligence about health plan claims processing trends, alongside coding and referential tools to increase productivity, reduce denials and prevent delays.
The Medical Group Management Association (MGMA) estimates that 30 percent of claims are rejected due to errors or omissions, and that physician practices incur rework costs of between $25 and $30 per claim. By improving first-pass acceptance rates, say executives, physician practices can dramatically improve their financial performance and support efforts to eliminate billions of dollars in administrative waste from the healthcare system.
Remit Advice Professional combines RemitDATA’s TITAN solution, which provides sophisticated post-payment analytics of medical claims remittances, with OptumInsight’s EncoderPro.com claims coding tools.
[See also: RemitDATA helps docs and vendors see how they stack up.]
By accessing these capabilities from within the Remit Advice Professional platform, physician practices get insight into past claims denial rates and the reasons they were denied by each health plan – along with the tools they need to take corrective actions that will increase future first-pass claims acceptance rates and reduce administrative costs.
The combined solution also provides physicians with a unique ability to compare their performance with that of peers in their specialty, execs say.
“Combining health claims comparative analytics from RemitDATA’s TITAN engine with OptumInsight’s comprehensive coding and referential tools will help physician practices make tangible improvements to their financial performance that will reduce denial rates, anticipate audits, accelerate cash flow and increase administrative efficiencies,” said Dave Ellett, CEO of RemitDATA. "By delivering these advanced capabilities, OptumInsight and RemitDATA are making it easier for physician practices to access resources that support better practice management decisions.”
TITAN provides real-time, relevant analysis of RemitDATA’s database of more than 350 million of the estimated 1.5 billion electronic medical claims remittances processed in the United States each year. Analytics give users insights into the average number of days it takes for health plans to process payments, their claims denial and reimbursement rates and the reasons for denying rejected claims. TITAN also enables users to compare their performance to state and national averages over time in order to identify trends and anticipate audits.
[See also: Ingenix unveils CareTracker solution for community health centers.]
“Our collaboration with RemitDATA delivers a solution that helps physician practices get paid faster and reduce administrative costs,” said David Schultz, vice president, coding solutions at OptumInsight. “TITAN brings unmatched claims remittance analytics capabilities that will enable physicians using Remit Advice Professional to assess and compare their claims performance to state and national denial rates to identify trends and potential audit triggers. The solution’s complete set of reporting tools gives physicians the resources they need to improve their acceptance rates and avoid costly delays.”
