What is your Claims First-pass Ratio? |
Posted: October 31, 2013 |
Healthcare Facilities, Providers and the US medical billing companies that handle their billing, have faced a lot of complexities during medical claims billing. As they already have too much to handle, adapting to the new changes introduced by the Affordable Care Act is truly burdening. The claims get denied by the Payers before they can get a handle on the new coding updates and this result in a poor first-pass ratio. So, what is this first-pass ratio? See below to learn its importance: What happens after billing a claim? There are two stages at which claims can possibly get denied and it is essential that Providers and outsourced medical billing companies understand the first-pass ratio and its importance.
First-pass Ratio: When a Provider or an outsourced US medical billing company uploads say, for instance 100 claims, to the clearinghouse and if 20 claims get rejected, then the first-pass ratio is 80%. If this claims rejection is eliminated, then the claims can easily pass through to the Payer level accounting for quicker reimbursement. On the other hand if erroneous claims are submitted, then they will get denied at the Payer level, causing more work like AR pile-up and TFL issues. To Improve First-pass Ratio:
Many US medical billing companies are at risk of losing their hard earned goodwill from clients due to poor first-pass ratio and re-work, due to the changes in the healthcare domain. They also lose a big chunk of their profit margins, if a higher % claims need to be re-worked or handled by AR as Denials. One of the best solutions would be to outsource medical billing functions to an offshore medical billing company that has a higher first-pass ratio. One such company is eCare! About e-Care India: e-Care India is one of the renowned medical billing companies in India that promises the above mentioned benefits with total customer satisfaction. With 13 years of experience in the industry, e-Care’s 3 offshore medical billing delivery centers have been providing end-to-end medical claims billing services seamlessly to its clients. To know more about e-Care and its services, log on to www.ecareindia.com
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