Adopting a data-driven approach to underpayment recovery

Healthc Financ Manage. 2011 Feb;65(2):58-62.

Abstract

Using a data-mining tool to improve its underpayment recovery process, Presbyterian Health Services in Albuquerque, N. M., achieved the following results: Recovered $8.21 million in less than eight months of implementation and an additional $17 million in the 12 months that followed. Increased staff productivity by 100 percent in less than six months, allowing auditors to resolve 40 to 50 claims per day versus 20 per day prior to implementation.

MeSH terms

  • Economics, Hospital*
  • Insurance, Health, Reimbursement*
  • Patient Credit and Collection / organization & administration*
  • Uncompensated Care*
  • United States