Slashing the High Cost of Administration in Healthcare

Healthcare is one of our most document-intensive and highly regulated industries.  Spiraling costs are exacerbating the financial crisis in the U.S. as the costs of care and health insurance are driven up.  One area that demands attention is the relatively high cost of administration in the healthcare industry in our country. 

According to T. R. Reid in his recent book, The Healing of America, the U. S. spends 20% of our healthcare dollars on administration compared to 4% in France (one of the countries with the lowest relative cost of administration).  At the recent Kofax Transform conference, Alan Kerr, Executive Vice President, Field Operations, stated that those costs are as high as 31% as reported in the New England Journal of Medicine. 

Regardless of your politics, I think we can all agree that something needs to change.  We've heard a lot in the news about digitizing patient records, x-rays and medical charts, but what about claims processing and back-office administrative processes?  At Digital Designs we are seeing increasing attention to all paper-intensive processes in the healthcare industry. 

One client, a third-party administrator with a paperless workflow already implemented, added advanced data capture to eliminate manual data entry from HCFA and UB-92 claim forms.  Not only did they dramatically reduce the time and labor required to enter the data required to pay the claims, but they also were able to capture much more information than they had been able to manually enter from the forms.  That resulted in a richer knowledge base made available to their adjudication system with the added benefit of more accurate claim payments and cost savings they could pass along to their clients.

Another client, a large surgical clinic, recently implemented an advanced capture and digital workflow for claim payment processing.  Because of lengthy, complicated payment cycles, documents were often lost in the manual process.  Now, documents are automatically routed in digital form to the individuals responsible for handling each patient account based upon pre-established business rules.  Disputed payments are handled more promptly, no documents are lost, and costs are dramatically reduced.

And another client, one of the top 100 hospital groups in the country, is implementing online pay stubs and W-2s for their 10,000 associates.  Each employee is able to view and print pay stubs and/or W-2s on demand, drastically cutting production, distribution and HR services costs system wide.  Payback is achieved in an astounding 4 months with savings dividends paid year after year.

Whether it's healthcare, business, manufacturing, distribution, entertainment, government or education, reducing costs through innovation can help speed our economic recovery and help us build a sustainable future.  To learn more about how Digital Designs can help your organization leverage the power of digital document automation, visit or call us at 800-948-6293.

John C. Queen