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Medicare Compliance & Reimbursement

Industry Notes:

AMA Report Card Ranks Payers, Finds 19.3 Percent Claims- Processing Error Rate

Published on Tue Jun 21, 2011

Physicians received no payment at all on nearly 23 percent of claims submitted to commercial payers. The American Medical Association (AMA) released its fourth annual National Health Insurer Report Card (NHIRC) last month, and the findings don't paint a pretty picture. According to the AMA, commercial payers show an average claims processing error rate of 19.3 percent. That represents a two percent increase over last year. "A 20 percent error rate among health insurers represents an intolerable level of inefficiency that wastes an estimated $17 billion annually," said AMA Board Member Barbara L. McAneny, M.D., in the AMA press release. "Health insurers must put more effort into paying claims correctly the first time to save precious health care dollars and reduce unnecessary administrative tasks that take time and resources away from patient care." UnitedHealthcare was the only payer included in the 2011 report card that showed an improvement in claims-processing [...]
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