The coding department of a large physician clinic is interested in purchasing a software program that will edit claims before they are sent out to billing. The license fee for the software costs $34,000 per year. The software is expected to reduce the number of errors on claims and thus reduce the number of claims returned to the clinic for recording. Currently the department codes 24,000 physician visits per month and 250 claims are returned each month for recoding. The facility pays two FTEs in the business office $9.50 per hour each to refile the returned claims. The software company promises that its software will reduce the number of returned claims by 90 percent. What is the rate of claims that are currently being returned for recoding?
To determine the rate of claims that are currently being returned for recoding, we need to divide the number of claims returned by the total number of claims submitted.
Currently, the department codes 24,000 physician visits per month, so the total number of claims submitted is also 24,000.
The number of claims returned each month is 250.
To find the rate, divide the number of claims returned by the total number of claims:
Rate = (Number of claims returned / Total number of claims) * 100%
Rate = (250 / 24,000) * 100%
Calculating the rate:
Rate = 1.04%
Therefore, the rate of claims that are currently being returned for recoding is approximately 1.04%.