Texas Tech University Health Sciences Center
CEO Minute: Reducing Denials With a Simple Rule

CEO Minute: Reducing Denials With a Simple Rule

CEO Minute: Reducing Denials With a Simple Rule- image0Texas Tech Physicians of Lubbock files thousands of claims each year. A percentage of these are denied the first time they are submitted. We know that the rate for better performing practices is approximately 3 percent and Texas Tech Physicians is a bit above that rate. We also know that a leading cause of denials centers around eligibility issues

Now, here is the kicker — the cost of managing those denials is approximately $25 per claim, which means that we spend a lot of money every month working denials that could have been eliminated by carefully checking each scheduled appointment before the patient arrives to assure the person has third-party coverage. We even have automation to help with the process. A rule of thumb is that four individuals in the Business Office “touch” a denied claim. That is a lot of touches, time, and waste of talent.

I will date myself, but one of the most influential books on minimizing mistakes is from 1979. It is Philip Crosby’s “Quality is Free.” I can summarize the book for you: when there are no defects, there is no cost associated with fixing the problem; hence, quality is free. Basically, Crosby made a lot of money telling you what a grandparent probably told you: “Do it right the first time.” Good advice the first time you heard it… and good advice today.

P.S. I am not pointing fingers. This advice applies to me as well. I usually violate the “do it right the first time” rule when I rush, try to cut corners, or the classic, fail to read the instructions. When we are tempted to rush… remember that quality really is free.