 |
Facts
Has the "Business of Medicine"
Overwhelmed
the "Practice of Medicine"?
Interesting Facts about the Average Healthcare Practice:
-
12%-15% of provider practice incomes are from self-pay revenue. (MGMA)
Co-pays alone can amount to over a half the reimbursement for an office visit (i.e., $20 - $50), depending on primary care or specialist. Also, out-of-network fees can be up to 50% out-of-pocket.
-
Experts feel that once a patient leaves the office, there is between 50%-95% chance of being paid, but, after 60 days, the experts agree the chances are almost nil. (PhysiciansPractice.com)
-
Initial claims denial rate nationally is 30% before re-submittance. Half of initially denied claims are never re-submitted (i.e., bad debt). Denial rate after claims re-submittance exceeds 10% in most practices (i.e., bad debt). Medicare and Medicaid deny 26% of all claims initially. Then only 40% resubmit. So, about 11% total net claims are not re-submitted or denied (i.e., bad debt). Denied and re-submitted claims cost triple the cost of single correct claim. (PhysiciansPractice.com)
-
Accounts Receivable (A/R) average aging: 55% of accounts 0-60 days, 64.2% are 0-90days, 35.8% are greater than 90 days, and 29.3% are greater than 120 days. Average number of days to collect is approximately 92 days. (AMGA)
-
Two major causes of bad debt are inaccurate information at registration (i.e., name, address, etc.) and increased mobility of population (no forwarding info, bill is returned). (Healthcare Financial Management Assoc.)
|
|
|
|
|
|
|
|
|
|
|
|
|
