average physician accounts receivable days in group health

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Request for Question Clarification by aceresearcher-ga on 22 Oct 2002 18:14 PDT

>>Thank you for your response.  Can this be bifurcated into average
>>inpatient A/R days and physician outpatient A/R days (professional
>>component only)?  Thank you so much for your response.
 
>>Nora Blay

Can you define what you mean by "professional component only"?

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Clarification of Question by nora-ga on 23 Oct 2002 08:13 PDT

The professional component is the physician component of the service
only and not the hospital charges (either inpatient or outpatient
hospital charges).  It is what the physician charges for his/her
services.  Thank you.

Nora

Because one of the standard practices of less reputable health
insurance providers was to delay processing of claims payments for as
long as possible, many states have instituted "Prompt Pay" laws.

An excellent comprehensive document of the laws by state, prepared by
KarenZupko & Associates, Inc., is available. This document (updated in
June 2001) contains links to many of the actual state laws in addition
to a summary of the provisions.
http://www.karenzupko.com/Resources/tools/Downloads/prompt%20pay%20pages.pdf

These state laws vary from a maximum of 15 days to a maximum of 60
days allowed, and many states have also passed laws requiring insurers
to pay interest penalties on payments which were not made within the
completed time frame.

The ACTUAL average time lapse on health insurance reimbursements is
much murkier. Some health insurers are very prompt and reliable;
others are still the recipients of complaints and legal proceedings
due to their unreliability or deliberate slowness.

An Oregon Medical Association survey published in January 2001 using
data from "71 medical offices in all areas of the state involving
247,717 patients and 666,654 claims... doctors waited an average of
40.5 days for payment... Average time from submission of the claim to
receipt of payment ranged from 33.3 days to 53.7 days among the
commercial health plans... Average payment delay for workers'
compensation insurers was 46.9 days, and among Medicare or Medicaid
insurers, ranged from 32.4 to 64.2 days.
http://www.ormedassoc.org/tk/pp/prompt_payment.html

The 2002 Median Ratios for Nonprofit Hospitals and Health Care Systems
by FitchRatings.com states that
"Days in accounts receivable significantly improved, declining 8.8% to
63.1 days, from 69.2 days in the previous year." [Bear in mind that
this is ALL accounts receivable, and not just A/R billed to insurers;
that may explain the dramatic difference from the Oregon study.]
http://www.fitchratings.com/corporate/reports/report.cfm?rpt_id=151370

Unfortunately, I did not have much luck finding other data specific to
A/R reimbursements from *only* health insurers.

health insurance providers reimbursement "payment within * days"
://www.google.com/search?hl=en&lr=&ie=UTF-8&oe=UTF-8&q=health+insurance+providers+reimbursement+%22payment+within+*+days%22&btnG=Google+Search

health insurance industry average reimbursement "within * days" study
://www.google.com/search?hl=en&lr=&ie=UTF-8&oe=UTF-8&q=health+insurance+industry+average+reimbursement+%22within+*+days%22+study&btnG=Google+Search

If you feel this response satisfies your question, let me know and I
will post it as an answer. If you have any questions about this
information, post a Request for Clarification, and I will try to help
you out.

I hope this information is of assistance to you!

Thank you for your response.  Can this be bifurcated into average
inpatient A/R days and physician outpatient A/R days (professional
component only)?  Thank you so much for your response.

Nora Blay

nora,

Information broken out this way will be quite detailed, and if it is
available at all, it would most likely be in lengthy research reports
for sale. Unfortunately, that is out of the scope of this question for
this price.

This link is to the list of Corporate Health Care reports which I used
to provide you with information. You might try searching through these
reports to see if what you are looking for is available. (You will
probably have to do free registration and enable cookies to access
this information.)
http://www.fitchratings.com/corporate/sectors/criteria_rpt.cfm?sector_flag=2&marketsector=3

Good Luck!