A Study of the Efficacy of the Five Phase Recovery Process as a Method of Maximizing Reimbursements under the Third Party Collection Program
Final rept. 1990-1991
ACADEMY OF HEALTH SCIENCES (ARMY) FORT SAM HOUSTON TX HEALTH CARE STUDIES DIV
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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 Demings 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 facilitys 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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