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Electronic transactions could save healthcare industry $9.4 billion

January 12, 2017
by Tom Valentino, Senior Editor
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Adopting electronic business transactions to replace manual transactions could save the healthcare industry at large $9.4 billion per year, according to data released on Thursday by CAQH, a not-for-profit alliance.

Per the CAQH Index, manual transactions cost U.S. health plans and providers an average of $6 more per transaction than when conducted electronically. Prior authorizations offer the most significant opportunity for cost savings. Such transactions currently take 20 minutes on average with a cost of $7.50 per transaction, but those numbers would drop to six minutes and $1.89 per transaction if conducted electronically, according to CAQH.

In its fourth year, the CAQH Index measures adoption, costs and provider labor time associated with administrative transactions between health plans and providers, such as: verifying patients’ insurance coverage, payments and status checks on claims. Findings for the 2016 index are based on voluntary nationwide surveys of providers, and commercial medical and dental health plans. Participating medical health plans represent about 46% of the commercially insured U.S. population and conducted 5.4 billion transactions in 2015.