Simpler Medical Billing Saves $7 Billion

BOSTON, April 29 (UPI) — Simplifying and standardizing administrative procedures for medical bills could save about $7 billion a year, U.S. researchers estimate.

Bonnie B. Blanchfield of Massachusetts General Hospital in Boston and colleagues have created a hypothetical model for medical billing that involves a single set of payment rules for multiple payers, a single claim form and standard rules of submission.


If doctors’ offices used the streamlined medical billing system they would save 4 hours a week of physician time and 5 hours a week of staff time, Blanchfield said.

The researchers analyzed the billing system of a physician’s group affiliated with a large, urban, academic teaching hospital. The researchers found 12.6 percent of submitted claims are initially rejected, but 81 percent are eventually paid — after using considerable staff time.

“The savings from reducing administrative complexity could be translated into decreased costs in general,” the study authors said in a statement. “Mandating a single set of rules, a single claim form, standard rules of submission, and transparent payment adjudication-with corresponding savings to both providers and payers-could provide system wide savings that could translate into better care for Americans.”

The findings are published in the journal Health Affairs at http://content.healthaffairs.org/cgi/content/full/hlthaff.2009.0075v1.

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