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.
Website: https://drwilliammatzner.com
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.
