Like all businesses, physician practices are sustained by getting paid for the work they perform. But healthcare providers are unique, not only in having to wait about 30 days from time of service to insurance reimbursement, but also in the sense that their “buyers” (health plans) can use a host of reasons to deny that payment. On average, health plans deny 5–10 percent of the claims physician practices submit. 1 And even though the stakes keep getting higher, practices still don’t spend enough time on improving this aspect of revenue cycle management, says Ken Hertz, FACMPE, a principal consultant with the Medical Group Management Association (MGMA). “Expenses are going up, reimbursements are going down — and leaving money on the table is not an option,” he says. “We’ve got

Join for free to read