Dr. Bill Matzner (Simi Valley, California): Cost Effectiveness of Revenue Cycle Methods

Cost Effectiveness of Revenue Cycle Methods

Much has been written about the revenue cycle and how to recover insurance payments for medical services rendered. There are various methods to track the missing payments, and even ways to see what information is missing to attempt recovery. Various algorithms have been developed to more accurately determine where to find the missing data and subsequently and efficiently resubmit claims. Each of these different methods has various costs and utilities which can be analyzed.

Cost Effectiveness Analysis (CEA) is clearly an accurate method to determine which of these approaches is the most efficient to use. It can compare two different methods, or even a group of different methods used in unison to determine how the group of recovery methods act in total towards an efficient recovery of healthcare dollars. By using custom decision trees, one can explore the relationship between two or more of the recovery methods, and even rank the various methods. For example, some use a manual search to decide which accounts need to be resubmitted, whereas a more expensive automated search engine is available. Which to use? CEA can help figure that out. It can take into consideration how much one is willing to pay, and what ratios of recovery yield the most desirable returns for a given organization or situation. Since the construction of the CEA model is customized to a particular situation, a new or specific method can be examined and compared to standard approaches. This can lead to increased efficiency in recovery of insurance claims and better cash flow for the organization.

About William L. Matzner, M.D., PhD, FACP

Dr. William Matzner works in the area of healthcare economics consulting at Healthcare Analytics, LLC, in California. He graduated Phi Beta Kappa from Stanford University. He received his M.D. with Honors from Baylor College of Medicine. In 1988, he was the Solomon Scholar for Resident Research at Cedar Sinai Medical Center. Dr. Matzner subsequently was awarded a PhD in Neuro Economics from Claremont Graduate University. He is board certified in Internal Medicine and Palliative Medicine. He has researched and published extensively on the issue of reproduction and immunology in medical literature. He has been in private practice since 1989, specializing in Reproductive Immunology and Internal medicine.

Consulting Website: http://healthcareanalytics.biz

William Matzner, MD (Simi Valley, California), has been practicing medicine since 1989, Internal Medicine and Reproductive Immunology. M.D. with Honors from Baylor College of Medicine.

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