Extended A/R from Documentation-Related Soft Denials

$10K-20K annually (counselor time on Tricare member calls = 3-4 hours/week; beneficiary satisfaction impact; soft retention cost) • $10K-20K annually (low referral volume; military-specific rules = complex verification) • $12K-25K annually (counselor time on contract-specific member calls = 4-6 hours/week; member satisfaction impact; soft retention cost)

Billing manager maintains DPC compliance spreadsheet; manually audits claims for DPC-specific metrics; sends email requests to clinical staff for re-documentation; tracks contract penalties manually; coordinates with employer on compliance status • Billing manager maintains state-specific denial tracking spreadsheets; sends email requests to clinical staff for state-compliant re-documentation; manual claim rework in different submission portals per state; high administrative burden • Billing manager maintains VBC metric spreadsheet; manually audits claims for required quality indicators; sends email requests to clinical staff for re-documentation; tracks VBC organization communication; coordinates with VBC organization on metric compliance