NEW YORK – A new Healthcare Provider Benchmark Report from Tennr revealed that independent healthcare providers lose over 10% (or $2.2 million) every year due to claim denials that inevitably happen while managing their backlog of patient referrals.
Unlike large hospital systems that can better absorb administrative overhead, independent providers operate on razor-thin margins where every dollar counts. The financial strain they experience threatens their ability to remain in business, and more importantly, limits patient access to care. Even more concerning, existing data shows that almost half (46%) of all referrals disappear into a black hole (NIH), leaving patients without the care they need.
Tennr’s Healthcare Provider Benchmarking Report analyzed data from healthcare organizations using its platform to process tens of millions of patients, examining why insurance claims get denied and tracing those denials back to specific paperwork problems that happen early in the process. The study compared performance before and after using Tennr’s platform while adjusting for organizational differences, such as their size, types of insurance they work with, services they provide, and where they’re located.
Key Findings
10% (or $2.2 million) of revenue lost annually: Independent providers lose this amount in revenue each year when intake paperwork is missing the information that insurers require to approve a patient’s treatment. These errors delay care and can cause patients to skip care altogether.
Productivity varies widely: The study reveals massive differences in how much patient intake and processing teams can handle – Traditional manual processing averages fewer than 100 orders per full-time employee weekly
The ‘hidden loss fallacy’
Independent providers are being swallowed up by national chains, and those that remain are struggling to stay afloat. “Most providers are dealing with what we call the ‘hidden loss fallacy’, where they’re pouring time and money into fixing billing issues after the fact, when the real opportunity is catching mistakes and missed patients earlier in the referral process,” said Trey Holterman, co-founder and CEO of Tennr. “Our data shows that the majority of costly claim denials are conceived during the initial referral intake process, not during billing.”