Revenue cycle and patient access operations are measured on denial rates and days in A/R. But the true cost of resolving a patient inquiry, authorization request, or billing dispute is 2-5x higher than the per-contact metric suggests — hidden inside rework loops, callback chains, and coding escalation patterns.
Prior authorization requests that require 2-4 follow-up calls to payers before resolution. Each callback adds $12-18 in agent time and 1-3 days in cycle time, but is logged as a separate contact.
Denied claims that cycle through rework queues 2-3 times before appeal or write-off. The rework cost often exceeds the original claim value, but is buried in aggregate denial rates.
Complex coding questions that escalate from patient access to billing to clinical coding and back. Each handoff adds cost and error risk. Resolution takes 5-10 touches across 3+ departments.
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