I’m about half-way through the first annual Survey of Workers Compensation Bill Review, and already there are a few somewhat surprising findings. These are very preliminary, but nonetheless intriguing.
1. The range of pricing for payers using external bill review vendors is broader than I expected, even after accounting for differences in services provided and volume. The range is over four dollars per bill.
2. Payers’ views of bill review vendors are diverse, with some payers enthusiastic about a particular vendor and others disdainful.
3. A majority of respondents voiced concern about their vendor’s inability to keep up with fee schedule and regulatory changes, and the negative impact this has had on the payer.
4. Regarding the use of UCR databases, some respondents are quite concerned, while others (primarily ones who are not using the Ingenix MDR/PHCS databases) are much less concerned. All respondents are well aware of the issue.
5. Most respondents view bill review as unnecessarily complex, difficult, time-consuming and expensive. The perception is much more of the bill intake, triage, review, repricing, and transmittal processes should be automated, with far fewer bills requiring human intervention.
The survey final report will be completed in mid-May; non-respondents can request a public version of the report by sending an email to infoAThealthstrategyassocDOTcom (substitute symbols for CAPS).
Apr
17
