Secondary Claim Filing Rate

The Secondary Claim Filing Rate is a healthcare revenue cycle management metric that measures the percentage of claims that are submitted to secondary payers after the primary payer has processed the claim. This metric is important because it helps healthcare organizations identify opportunities to improve their revenue cycle management processes and maximize their reimbursement rates.

A high Secondary Claim Filing Rate indicates that the healthcare organization is effectively submitting claims to secondary payers, which can result in increased revenue. On the other hand, a low Secondary Claim Filing Rate may indicate that the organization is missing out on potential revenue opportunities.

Secondary Claim Filing Rate is calculated by dividing the number of secondary claims filed by the total number of claims submitted. The resulting percentage represents the rate at which secondary claims are being filed for a given period. For example, if a healthcare organization submitted 1,000 claims and filed 200 secondary claims, the Secondary Claim Filing Rate would be 20%. This metric is important because it measures the efficiency of the organization's revenue cycle process in terms of submitting secondary claims. A low Secondary Claim Filing Rate may indicate a need for process improvement or staff training to ensure that all eligible claims are being filed in a timely manner.

Best practices to improve Secondary Claim Filing Rate are:

1. Timely submission of claims: It is essential to submit secondary claims within the stipulated time frame to avoid claim denials. The ideal time frame for submitting secondary claims is within 30 days of receiving the primary payment.

2. Accurate claim information: Ensure that all the necessary information is included in the secondary claim, such as the correct patient information, diagnosis codes, and procedure codes. This will help to avoid claim rejections and denials.

3. Automated claim submission: Implementing an automated claim submission process can help to reduce errors and improve the efficiency of the claim submission process. This can be achieved by using electronic data interchange (EDI) or other automated systems.

4. Regular monitoring of claim status: Regularly monitoring the status of secondary claims can help to identify any issues or errors that may be causing delays or denials. This can help to address these issues promptly and improve the overall secondary claim filing rate.

5. Staff training and education: Providing regular training and education to staff members involved in the secondary claim filing process can help to improve their knowledge and skills, leading to improved accuracy and efficiency in the claim submission process.

6. Use of technology: Utilizing technology such as revenue cycle management software can help to streamline the secondary claim filing process and improve overall efficiency. This can help to reduce errors and improve the accuracy of claim submissions.By implementing these best practices, healthcare organizations can improve their secondary claim filing rate, reduce claim denials, and ultimately improve their revenue cycle management process.

The industry standard benchmark for Secondary Claim Filing Rate is 95%. This means that healthcare organizations should aim to file at least 95% of their claims correctly on the first submission. The remaining 5% of claims may require a secondary submission, which can result in additional costs and delays in payment.

To achieve this benchmark, healthcare organizations must ensure that their claims are accurate and complete before submitting them. This includes verifying patient information, ensuring that the correct codes are used, and submitting all necessary documentation.

In addition to improving the efficiency of revenue cycle management, meeting the benchmark for Secondary Claim Filing Rate can also improve patient satisfaction. Patients are more likely to have a positive experience when their claims are processed quickly and accurately, which can lead to increased loyalty and referrals.Overall, the benchmark for Secondary Claim Filing Rate is an important metric for healthcare organizations to track and improve upon. By striving to meet this benchmark, organizations can improve their revenue cycle management processes and provide better care to their patients.

Revenue cycle software can significantly improve the Secondary Claim Filing Rate metric by automating the process of identifying and correcting errors in claims before they are submitted for secondary filing. With the help of advanced algorithms and machine learning, the software can detect errors such as missing information, incorrect coding, and other issues that can lead to claim denials or rejections.

By addressing these errors before the claims are submitted for secondary filing, revenue cycle software can significantly reduce the number of denied or rejected claims, thereby improving the Secondary Claim Filing Rate metric. Additionally, the software can also help healthcare organizations track the status of their secondary claims and identify any issues that may be causing delays or denials.

If you're interested in seeing firsthand how revenue cycle software can improve your organization's Secondary Claim Filing Rate metric, we invite you to book a demo with MD Clarity. Our revenue cycle software is designed to help healthcare organizations streamline their revenue cycle processes and improve their financial performance. Contact us today to learn more!