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  • JAMA, the Journal of the American Medical Association

Administrative Costs Associated with Physician Billing and Insurance-Related Activities at an Academic Health Care System

By: Phillip Tseng, Robert S. Kaplan, Barak D. Richman, Mahek A. Shah and Kevin A. Schulman
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Abstract

The federal government mandated adoption of certified electronic health record systems (EHR), at least in part, to reduce administrative costs for physicians. This study used time-driven activity-based costing to determine the administrative costs associated with billing and insurance activities at a large academic health care center that had a certified EHR system. The center enjoyed economies of scale by concentrating its bill paying functions within a single, dedicated unit. The study found that costs for processing a single bill ranged from $20 for a primary care visit, about 20% of revenues, up to $215 for an inpatient surgical procedure. The high costs were not caused by wasteful, inefficient processes, duplicate or redundant tasks, or the inappropriate use of high-wage personnel to perform low-skilled tasks. Rather, they were driven by the heterogeneous payment requirements across the multiple payers and health plans contracting with the academic health center.

Keywords

Health Care and Treatment; Cost Management; Insurance; Problems and Challenges

Citation

Tseng, Phillip, Robert S. Kaplan, Barak D. Richman, Mahek A. Shah, and Kevin A. Schulman. "Administrative Costs Associated with Physician Billing and Insurance-Related Activities at an Academic Health Care System." JAMA, the Journal of the American Medical Association 319, no. 7 (February 20, 2018): 691–697.
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About The Author

Robert S. Kaplan

Accounting and Management
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  • Comparison of COVID-19 Hospitalization Costs across Care Pathways: A Patient-level Time-driven Activity-based Costing Analysis in a Brazilian Hospital By: Ricardo Bertoglio Cardoso, Miriam Allein Zago Marcolino, Milena Soriano Marcolino, Camila Felix Fortis, Leila Beltrami Moreira, Ana Paula Coutinho, Nadine Oliveira Clausell, Junaid Nabi, Robert S. Kaplan, Ana Paula Beck da Silva Etges and Carisi Anne Polanczyk
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