Slideshow Revenue Cycle Insights

  • May 30 2012, 5:47pm EDT
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Revenue Cycle Insights

Medicare gets good grades on its response time in paying
claims—and it’s also one payer highly connected with the
industry. That was one finding from a recent survey conducted by EDI vendor, Ivans. The survey results, from 709 health care providers, are highlighted here.

Good Grades for Medicare…

Medicare is fair either all or most of the time with its reimbursements, according to 93 percent of the providers surveyed. Likewise, about two-thirds also said Medicaid was fair in its payments. Commercial payers, however, were another story (see next slide).

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… But Poor Marks for Commercial Payers

Only 37 percent of survey respondents said that their commercial payers were fair most or all of the time, with 49 percent saying commercial payers are only fair some of the time. Less than one percent submit claims on paper to Medicare, while almost 40 percent still submit paper claims to commercial payers.

Audits Are Common…

More than 60 percent of providers have been audited by Medicare. The federal payer has stepped up its audit program in an effort to recapture what it says are $35.4 billion in improper payments, the survey notes. But the industry endorses the effort (see next slide).

…But Valuable

Nearly 80 percent of respondents say that RAC audits—one of several Medicare reimbursement review programs underway—are helping to reduce fraud and errors. One-third cited fear of non-compliance as their biggest concern about a RAC audit.

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Mixed Findings for EHRs

The survey found that 42 percent of providers currently use an EHR and 37 percent have attained meaningful use. Another 25 percent said they would qualify within a year. However, 39 percent of respondents have no plans as yet to attain meaningful use.

For More Information

To read the full report, click here.