Archived Publications eBook: The Dollars are in the Details | Page 15

WOEFUL INEFFICIENCY
Our research shows that approximately 56.6% of respondents
use some type of software solution to help automate their
processes—packaged provider enrollment software (46.3%),
packaged software not specifically designed for provider
enrollment (5.7%), or in-house customer software (4.6%).
However, many respondents still manage their work using
Excel spreadsheets (42.7%), calendar alerts (25.3%), Word
documents (16.0%), or manual processes (14.2%).
Q. How much notice do you typically have to start individual provider
enrollment prior to the provider’s start date? (Base = 286)
53.8%
%
46.3%
Packaged provider enrollment software solution
42.7%
Excel spreadsheet
38.8%
Combination of software and paper process
25.3%
Calendar alert
16.0%
Word document
14.2%
Manual, paper-based process
5.7%
Packaged software solution not designed for provider enrollment
In-house customer software 4.6%
SharePoint document 3.9%
2.1%
None
0
60
20
40
60
“Our survey brings to life the pitfalls and complexities of today’s provider enrollment
process for most healthcare organizations. The typical organization processes an average of
18 enrollment applications per provider per year for approximately 250 providers—totaling
4,500 applications annually per organization. Each of these applications requires numerous
phone or email follow-ups with payers and others to ensure timely provider enrollment and
billing. Despite its importance, this work is being managed in many organizations with Excel files, calendar
alerts, and paper forms. It’s clear that automated solutions are long overdue.”
-Tonya Nevin, Vice President, Medical Practice Products and Solutions, DecisionHealth
CONCLUSION
The financial impact of a poorly managed provider
enrollment process is highly detrimental in any healthcare
organization. A hospital, healthcare organization, or medical
group can suddenly find itself losing significant amounts of
money and facing highly dissatisfied patients and providers.
As shown by our recent survey, the importance of provider
enrollment is being elevated to an all-time high.
Given the new payment reforms that are coming with
downward pressure on revenues, upcoming changes in
physician reimbursement, revalidation, and many other
initiatives, is your hospital, healthcare organization, or medical
group ready to thrive in this new environment? What can
you do today to position yourself for the coming changes?
References:
Cutler, David Ph.D., Elizabeth Wikler, B.A., and Peter Basch, M.D. “Reducing Administrative Costs and Improving the Healthcare System,” N Engl J Med
2012; 367:1875-1878, November 15, 2012, DOI: 10.1056/NEJMp1209711, http://www.nejm.org/doi/full/10.1056/NEJMp1209711
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Reprint from SUMMER 2016 Provider Advisor
15