I used to run bank call centers. Every month we calculated the cost to answer customer calls with a human. The cost was incredible, about $4.50-8.00 per call depending on the agent and complexity of the contact.
When we launched internet banking (this was a long time ago) our call volume dropped about 35% in a month. The cost to handle an internet banking inquiry was about $0.35. We were able to close call centers and consolidate our operations quickly and our satisfaction ratings soared.
I can imagine that the cost to handle a healthcare insurance call today is probably pushing $15-$20. Those agents are on the call for 20-30 minutes at a time. So, $21 Billion wasted on those calls seems reasonable.
Now…consider that medical coding is half assed most of the time. If you clean up the input, the costs on the recovery side drop like a rock.
When my wife was undergoing cancer treatment we had to pick apart every bill because the coding errors were so egregious. Over 18 months we NEVER got a bill that did not need correction.
In the past couple of years the hospital system integrated a better billing system where everything is scanned into the chart. The result is much better billing and payments. It’s saved us a ton of time and everything gets approved and paid faster.
“System” related waste is a huge thing. In government it has to be incredibly bad because their systems and people are calcified.
I heard it reported that the government does not know the “overhead” costs of running Social Security, Medicare, etc because they don’t track it. How can they work to make bureaucracies more efficient if they don’t track the costs?
Now…consider that medical coding is half assed most of the time. If you clean up the input, the costs on the recovery side drop like a rock
Yep, Gawd forbid you enter the code in for a head injury caused by walking into a metal lightpole instead of a concrete based one. Even worse if the diagnosis was supposed to be concussion with nerve damage and the wrong entry changed it to
congestion.