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Business

Average medical practice may lose as much as 11% of its revenue due to underpayments. But underpayment recovery potential averages only 5% of revenue and involves costly appeal process. To avoid unrecoverable losses, some providers discontinue servicing patients insured by the worst performing payers. Unfortunately, such a drastic loss reduction measure may boomerang and increase losses depending on complexity of referral relationships.

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Fortunately, modern database query technology can address both limitations by enabling "second order SQL" queries, which allow data manipulation based on multiple criteria and using functions of combinations of such criteria.In our case, second-degree SQL queries allow finding the worst payer for best revenue generating code. Such a discriminating approach allows focusing on higher priority items first, resulting in more effective management.

 

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