Practice Management Alert

Payer Updates:

Check Your Payers Against the AMA's 2009 Report Cards

See which payers rank highest in 6 billing categories.

Are you curious about where your top payers stand among other payers? The AMA posted its National Health Insurer Report Card, which can give you the answer. According to the "report card," the AMA evaluated Medicare and seven private payers on "critical metrics concerning the timeliness, transparency, and accuracy of claims processing." The private payers include Aetna, UnitedHealthcare, Anthem Blue Cross and Blue Shield, Cigna, Coventry Health Care, Health Net, and Humana.

The AMA evaluated these payers on metrics in the following six categories:

• Payment timelines

• Accuracy

• Transparency

• Claim edit sources

• Denials

• Improvements of claims cycle workflow.

The overall goal in the report card evaluation, which the AMA published in July, was to "improve the overall efficiency of billing and collections, thereby reducing the cost to both physician practices and payers," the report says. Note: To review the data and all of the specific metrics, visit www.ama-assn.org/ama1/pub/upload/mm/368/2009-nhirc-long.pdf.

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