AMA Report Card Shows Fall in Incorrect Claim Payment by Insurers

by | Published on Jul 11, 2012 | Healthcare News

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The findings mean that attempts to improve the efficiency of the claims process have been fruitful

Physicians noticed an overall soar in the percentage of insurance claims that were reimbursed correctly last year and a fall in the degree of hassles associated with receiving those claims on time. According to the fifth yearly National Health Insurer Report Card of the AMA, the percentage of claims reimbursed erroneously by insurers has come down by half. The exact percentage change is from 19.3 percent in 2011 to 9.5 percent in 2012. The health system thus saved $8 billion due to a decrease in administrative work. All this just goes to show that efforts to improve the efficiency of the claims procedure have met with success.

Anthem Blue Cross Shield, HCSC and Humana Leading

Anthem Blue Cross Shield showed the largest improvement in precision, with its accuracy rate soaring from 61 percent in 2011 to 88.6 percent in 2012. HCSC and Humana on the other hand, were found to be plans with the quickest response time. They had a six days median response time.

Room for More Improvement

Though accuracy has improved considerably compared to last year, the AMA said that there is scope for further improvement. Insurers continue to pay erroneous sums for one out of every 10 medical claims. The result is a $7 billion loss to the healthcare system.

If you want to ensure that your physician coding is consistently accurate and always gives you savings instead of losses, it is advisable to consult a professional medical coding service provider.

Julie Clements

Julie Clements, OSI’s Vice President of Operations, brings a diverse background in healthcare staffing and a robust six-year tenure as the Director of Sales and Marketing at a prestigious 4-star resort.

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