What is a good benchmark for a well-managed timely filing billing function as measured by the ratio timely filing denials/total denials in dollars? Most of the information I find indicates it is 1% or less but I don’t have any solid statistic on the above ratio. Can you help?
Answer 1: To best measure timely filing, measure discharge to claims submission. Take the percentage of claims submitted within a certain number of days from discharge and then break it up by payer, as the timely filing criteria can change payer to payer. This would provide a good picture of how quickly claims are being sent after discharge.
This question was answered by: Suzanne Lestina, FHFMA, CPC, is director of administrative simplification policy, American Hospital Association, and a member of HFMA’s First Illinois Chapter.
Answer 2: I don’t know of industry standards, but I can share that ours is quite low, probably less than 1%.
This question was answered by: Ruth Landé, senior vice president, patient revenues, Memorial Sloan-Kettering Cancer Center, and a member of HFMA’s Metropolitan New York Chapter.
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