A Study of the Efficacy of the Five Phase Recovery Process as a Method of Maximizing Reimbursements under the Third Party Collection Program

Abstract

The results of this study demonstrate the effectiveness of the Five Phase Recovery Process as a method of maximizing reimbursements for hospitalization from third party payers under the Third Party Collection Program. The Five Phase Recovery Process was developed by the author and was tested for a six month period at a 65 bed Army Community Hospital. Implementation of the process was in accordance with Deming's Principles of Total Quality Management. The study included a survey of 4500 beneficiaries to determine the extent of private health insurance coverage. At the conclusion of the study, the collection rate increased by 62.66%, the claims paid rate increased by 38.53%, the claims generation rate increased by 120.00%, and overall all collections increased by 350.00% versus the previous fiscal year. The mail survey indicated that 32.95% of the facility's beneficiaries had billable health insurance, but only 6.95% of those with billable policies utilize the facility for their inpatient care.... Third party collection program, Reimbursement for hospitalization, Five phase recovery program, Third party payers.

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Document Details

Document Type
Technical Report
Publication Date
Jul 01, 1991
Accession Number
ADA261675

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  • Randy P. Buchnowski

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