Hospital Revenue Cycles Get a Boost from Simple JPEG Files
When it comes time for healthcare providers to get paid, forget complex algorithms and cutting edge reporting systems. It's the lowly JPEG—yes, the common PC image file format—that's bringing home the bacon.
So much of the sizzle of healthcare information technology seems like a tour of the bridge of the starship Enterprise, or perhaps a quick sprint through Starfleet engineering.
Sophisticated analytical algorithms tease out hidden provider or patient behaviors. Google Glass offers up in-clinic encounter hints and notes. Increasingly miniaturized mobile technology tracks "quantified selfers" who expect up-to-the-minute telemetry on what's ailing them.
But when it comes time for providers to get paid, the lowly JPEG, a common PC image file format, is bringing home the bacon.
According to the 2010 National Ambulatory Medical Care Survey, more than a billion ambulatory care visits per year produce claims or encounters with 13 percent requiring attachments, each of which averages 3.2 pages in length, before the payer could adjudicate the claim and pay the provider.
The annual claim denial rate in 2013 was 2.17 percent. That translates to managing more than 70 million attachment pages annually, as providers try to get paid by submitting (or resubmitting) appropriate documentation.
Boca Raton Regional Hospital, with 400 beds, is probably pretty typical when it comes to striving to get its claims paid. Rudy Braccili, Jr. is executive director of revenue cycle management and a previous leader of Tenet Healthcare's National Medicare and Medicaid Center in Florida.