100 Claims Overview

100 claims is about claims process benchmarks and looking at them as if the entire claims process were only 100 claims.

We have gathered claims process benchmarks for over 15 years. The purpose of the 100 claims series is to share those benchmarks in a meaningful and easy to understand manner.

Each benchmark is framed in a 100 claim context. If it were asked what percent of claims are facilty claims (UB92s) the 100 claim series answer would be 31 of the 100 claims are UB92. In certain circumstances we have stretched the 100 approach from claims to claim lines (100 claim lines) or from claims to claim dollars.

Our 100 Claims Series Benchmarks.

  1. UB92 and HCFA Claim Volume. (updated 4/16/07)

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Claim Attachments

17 Year Attachment Trend -- 1990 to 2007 (bar Graph)

According to our surveys and anecdotes the volume of claims with an attachment has dropped. The numbers we have indicate that between 1990 and 2007 claims with attachments have fallen from 1 in 5 claims to 1 in 20.

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For 100 Typical Claims: 31 UB-92/facility and 69 HCFA/Professional

Common rule of thumb: By volume 70% of claims are professional (HCFA) and 30% are facilty (UB).

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There are two surveys for Q2 2007:

EDI Survey

Goal: Gather the latest EDI trends

COB Survey

Goal: Gather the latest Claim Coordination and COB trends

Industry Calendar

Consumer Directed Healthcare Conference April 2007 -- Las Vegas

Institute 2007 - AHIP's Annual Meeting June 2007 -- Las Vegas

About the Publisher:

The ClaimHeader is published quarterly by Datamethod. To learn more about us, please visit our website at www.datamethod.com.