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The cost of billing and health insurance-related (BIR) paperwork in the U.S health care system is estimated at $471 billion, approximately 17% of the total $2.7 trillion United States National Health Expenditure in 2012.  BIR activities include functions related to interacting with payers, such as filing claims, obtaining prior authorizations, and managed care administration. BIR activities did not include clinically necessary tasks, such as patient scheduling or writing chart notes.
The 2012 total National Health Expenditure of $2.7 trillion includes two main expenditure categories, health consumption expenditures and investment, as follows:

$2.548 trillion for total . . .

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Managed Care Financing & Service Delivery Systems