Associate Professor of Accounting and Information Systems, Rutgers Business School, Rutgers University
The Interplay between Healthcare Information Technologies and Denied Claims
Abstract: This study investigates the role of health information technology (HIT) in reducing claim denials, which are a significant burden for healthcare providers in the U.S. We theorize the impacts of electronic health records (EHRs) on claim denials in three aspects: (i) EHR adoption and how EHRs are sourced (ii) within a hospital and (iii) across hospitals in the same health system. We put forth that while EHR adoption reduces the likelihood of claim denials by improving the accuracy and completeness of information processing, it can also increase claim denials if it is sourced from multiple vendors within the hospital or different vendors across the hospitals. With a large-scale dataset of claim records from the State of Maryland in 2012-2016, we find that the greater EHR adoption by care providers, the less likely a claim is denied. In addition, EHRs are more effective in preventing denials when a hospital sources EHR applications from a single vendor and when a group of hospitals adopt EHRs from the same vendors. Our results also suggest reduced claim denials when a physician is affiliated with multiple hospitals using EHR applications from the same vendor. This study provides significant theoretical insights for the information systems literature on HIT and enterprise systems and offers practical implications for healthcare providers by uncovering the multi-faceted roles of EHRs in information processing and compliance.
Bio: Dr. Hilal Atasoy is an Associate Professor of Accounting and Information Systems at the Rutgers Business School. She joined the faculty at Rutgers from the Fox School of Business at Temple University. She has a Ph.D. and a Master’s degree in Economics from the University of Illinois, Urbana-Champaign. Her research analyzes the consequences of digitization for society by focusing on digital transformation in healthcare and labor markets. She studies how information systems and the associated flow of information across providers affect healthcare outcomes and the impacts of information technology and innovation on labor markets. Dr. Atasoy’s research has been published in leading outlets such as Management Science, Information Systems Research, Production and Operations Management, and Industrial and Labor Relations Review.