Blog
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Read the remittance, not just the claim
A remittance settles one claim and describes a payer. Read across a quarter of them and a per-payer profile appears that nobody had to be told.
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Assemble the history before you start
The first minutes on a stalled claim go to rebuilding context that already exists. That work is retrieval, not judgement, and it need not happen then.
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What to write down when you work a claim
A note written for the next person is a different note from one written to prove that work happened, and only one of them saves anybody time.
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Paying twice for the same denial
The expensive part of working a denial is working out what it means. Most operations pay for that analysis again every time the denial recurs.
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Timely filing is a write-off schedule
A filing deadline is the one date on a claim that turns unfinished work into a permanent loss, and it is rarely the date your report shows you.
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The small balances nobody works
Small balances are abandoned by a rule nobody wrote down, and the total never appears in any report as a decision someone made.
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What the aging report leaves out
An aging report tells you how old a balance is and almost nothing about whether it will pay or what it needs done to it next.
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Queue time and work time
Most of a stalled claim's elapsed life is spent waiting to be picked up rather than being worked on. The two halves respond to different things.
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What a clean claim rate hides
A clean claim rate grades your intake. It says very little about whether the money arrives, and the two come apart in predictable ways.
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Flat cost, falling odds
The cost of working a stalled claim barely moves as it ages. The probability of payment does. That gap is what every triage rule is trading against.