Health Affairs

Health Affairs, 28, no. 4 (2009): w544-w554 (Published online 14 May 2009) doi: 10.1377/hlthaff.28.4.w544 © 2009 by Project HOPE	New Online   Reinhardt: Post-Summit   Report from the Summit   President's Reform Proposal   Rising Medicare Costs   Spending for Immigrants   $2.5 Trillion U.S. Health Tab   Child Obesity Briefing

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Peering Into The Black Box: Billing And Insurance Activities In A Medical Group

Julie Ann Sakowski, James G. Kahn, Richard G. Kronick, Jeffrey M. Newman and Harold S. Luft

Billing and insurance–related functions have been reported to consume 14 percent of medical group revenue, but little is known about the costs associated with performing specific activities. We conducted semistructured interviews, observed work flows, analyzed department budgets, and surveyed clinicians to evaluate these activities at a large multispecialty medical group. We identified 0.67 nonclinical full-time-equivalent (FTE) staff working on billing and insurance functions per FTE physician. In addition, clinicians spent more than thirty-five minutes per day performing these tasks. The cost to medical groups, including clinicians’ time, was at least $85,276 per FTE physician (10 percent of revenue).

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• Lawrence P. Casalino, Sean Nicholson, David N. Gans, Terry Hammons, Dante Morra, Theodore Karrison, and Wendy Levinson
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  [Abstract] [Full Text] [PDF] [Supplemental Exhibits & Appendix]
   
  

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				L. P. Casalino, S. Nicholson, D. N. Gans, T. Hammons, D. Morra, T. Karrison, and W. Levinson What Does It Cost Physician Practices To Interact With Health Insurance Plans? Health Aff., July 1, 2009; 28(4): w533 - w543. [Abstract] [Full Text] [PDF]