The rejection rates of claims bound for Blue Cross and Blue Shield plans appear to have returned to normal, but one-quarter or more of Medicare and Medicaid claims continue to be rejected one week after the National Provider Identifier implementation, according to Miriam Paramore, senior vice president of corporate strategy at Nashville-based claims clearinghouse Emdeon Business Services.
Paramore, who also serves as chairman of the Healthcare Information and Management Systems Society's financial systems steering committee, a work group for claims clearinghouses, said at least one of our (clearinghouse) peers is seeing a 25% Medicare rejection rate and a 37% Medicaid rejection rate.
We continue to be concerned about our customers on both sides, payers and providers, Paramore said, but for providers, even a small increase in rejections could mean millions and millions of dollars in lost or delayed revenue. The impact on provider cash flow wont be known until later, she said, adding that she has no solid numbers yet on the most frequent specific causes of the heightened rejection rates.
Its too early to answer that, she said. Give me to the end of next week, we should have some good numbers. -- by Joseph Conn
For more on the post-NPI claims rejection increase, see "Claims processors see rejections spike with NPI
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