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Saturday, 26 July 2008
 
 

Medical Billing Underpayment Risk Management

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Medical Billing Underpayment Risk Management

Average medical practice may lose as much as 11% of its revenue due to underpayments. Underpayment identification is difficult because an underpaid claim falls outside the domain of clearly identifiable claims that are fully paid or denied. The degree of underpayment adds further complexity to and exacerbates the difficulty of underpayment identification. Upon defining claim underpayment concept in more precise terms, this article roughly estimates recovery potential at 5% of monthly claims volume. Quantification of recovery potential drives the design of a disciplined three-stage underpayment avoidance and recovery process.
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