8 Key Areas Representing $13.3B in Cost Saving Opportunities for Healthcare Administration

HIT Consultant May 7, 2021
Scott Overholt, Director of Business Development, Vyne Medical

According to the 2020 CAQH Index report, an annual report published by the Council for Affordable Quality Healthcare, a study of eight key transactional areas revealed opportunities for cost savings totaling $13.3 billion for medical providers and plans willing to move to fully electronic administrative processes. The CAQH report examined eight key transactions: Eligibility and Benefit Verification, Prior Authorization, Claim Submission, Attachments, Coordination of Benefits, Claim Status Inquiry, Claim Payment, and Remittance Advice.

1. Eligibility and benefit verification

Of the 13.3-billion-dollar savings opportunity for medical organizations, the greatest area for cost savings – accounting for 51 percent of the total ($6.7 billion) – comes in the area of eligibility and benefit verification. With 84 percent of these transactions being fully...

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