How are you working with providers right now around maybe even specifically like COB, then absolutely. So the denials are my passion because, you know, they're unavoidable. We're always gonna have them. We're we're not getting to that point. But if we do our jobs properly We have an opportunity to really be effective at challenging these payers because they're sitting around thinking about how to challenge you you need to be doing the same thing. And what's interesting, David, is when I go to a client today and I get in our system and I look at a denial report, the denial categories that I see today in twenty twenty three are the same ones I was seeing in twenty ten. Wow. The same high level grouping of denials. And, you know, some facilities try and dive deeper and say, okay. What does that one really mean? Because, you know, we have standardization in these claim adjustment reason codes, but then the remarks are different for every pair. So you can have five remarks from five different pairs mean the same thing. You've got to map to understand exactly what that payer's doing to you at every payer. And it's not a small task. No. But the dividends that could pay are worth the effort. And let me explain. So typically coordination and benefit denials, which is something I've only been seeing for the last five years, and it's getting worse. Hundreds of millions of dollars being lost at hospitals because we eventually give up. I end up in bad debt. So this is the most interesting concept to me. So a patient comes into the facility We provide services, we provide care, and we bill their insurance company. And the insurance company we have reason to believe that David might have some other insurance coverage. You need to you need to get with the patient and tell him to call us. Wait a minute. The patient pays their premium to you. I provided a service and you want me to call your customer to get them to call you. And then it just becomes a shell game. Yes. Yes. It is. We actually do this. We call the patient Generally three times, we send a couple of letters. And then the unfortunate problem is when we don't get the response, The hospital really has no choice but to flip it to self pay. Ultimately, we're responsible for our bill. Typically, when we do that, we get the angry call. And we're the ones that look like the evil one. Right? Because we've started charging you for something when you know you have insurance. We explain the situation. Your insurance company, you need to call them. They believe you have other coverage, can you call them and clear this up? So they call their insurance company. And then they insurance company says, oh, there's no problem on this side. It's the way they billed it. So we get another angry call, and we're saying, trust us. Alright. We're gonna call your insurance company call it. We call the insurance company. Patient never called us. It literally happens every day. It's a shell game. And the problem with the coordination of benefits denial, there's no appeal. You can be a perfect patient access department and ask every patient that walks in that door. Do you have any other coverage? Is this a work incident? Is this a vehicle related incident? Did you have a slip and fall? You can ask all the right questions, patient says no. Nope. Nope. No other coverage. You know, does your husband have coverage? Does your spouse have coverage? Nope. This is it. This is our coverage. You can do everything right and still get that coordination of benefits denial. And the patient will probably get a letter from the insurance doesn't make sense to them. Yeah. I've got insurance. What do you mean? You know, this could be covered under another insurance. And the patient's like, what do you mean? I don't have any other insurance. Yeah. And so they don't know what to do with it. It it probably just goes in the waste bin. Yep. And then we're stuck. So here we are working now for our biggest nemesis, the payer, working on their behalf for them to do their job. It's a horrible, horrible thing, and it's costing us. Hundreds of millions over a billion dollars a year across the country. Hundred I mean, it's just insane. The amount of money lost because eventually cannot continue to put effort into that claim because you got ten more that came in today. Right.
