Data inaccuracies can impact claims management, referrals, surprise medical bills, and much more. Blue Cross of California had to pay a whopping $38 million in refunds to members in 2015 as a result of inaccurate data. A new report from Orderly Health seeks to shed light on the issue and highlight how its services can help.
Without automation, call centers cost, on average, $1 per minute to carry out data verification. It can take more than four minutes to complete data verification by phone, according to a report by America’s Health Insurance Plans, or AHIP. It means that provider outreach through call centers costs roughly $4
per provider per location.
Insurance companies spend an estimated $2 billion to $4 billion per year to improve the accuracy of their provider data, excluding costs associated with regulatory actions, according to the report.
There’s a clear disconnect between payers and providers regarding these data
validation requests. Clinicians and their staff expressed “a general lack of awareness” and “did not understand the purpose” of the data verification processes, leading them to feel “overwhelmed with responsibility”, according to the report from Orderly.
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