Health Care Quality Special Reports

Report Says Insurers Need to Improve Claims Payment Accuracy July 2010 Reimbursement The U.S. health care system could save $777.6 million in unnecessary administrative costs if health insurers improved their claims-payment accuracy rates by just 1%, the American Medical Association (AMA) said in a report last month. Increasing health insurers’ payment accuracy rate to 100% would save $15.5 billion annually, the AMA said. That money could be put to better use to improve patient care and reduce overall health care costs, the AMA added. Health insurers process only about one in five medical claims inaccurately, according to the AMA’s third annual report on the nation’s commercial health insurers and the systems they use to manage and pay claims. The AMA’s 2010 National Health Insurer Report Card rated the overall claims processing accuracy of the nation’s largest health insurers. Among the nation’s seven largest health insurers, Coventry Health Care Inc. was the best with a national accuracy rating of 88.41%, the AMA said. Anthem Blue Cross Blue Shield was the lowest at 73.98%, the AMA said. The health care system spends as much as $210 billion annually on claims processing, and one recent study estimated that physicians spend the equivalent of five weeks each year on health insurer red tape, the AMA report said. The cost to practices to keep up with the administrative tasks health plans require means that physicians must divert as much as 14% of their revenue to ensure that they get accurate payments from insurers. To encourage insurers to develop more efficient, streamlined payment systems, the AMA started the National Health Insurer Report Card in 2008. It provides a look at how each of the nation’s seven largest commercial health insurers can improve claims processing performance in the areas of accuracy, denials, timeliness, .... You must sign-in to read complete article. If you are not registered click here. Username: Forgot it? Password: Financial support for this Website is provided by Premier Healthcare Resource.

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