decisionhealth Newsletters, Part B News - 2011 Issue 7 (July)
Benchmark of the Week: Payer performance by service type, 2011
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Article Overview
This article reviews payer performance across broad service categories and compares private plans with Medicare using 2011 insurer report card data from the AMA. It is intended for coding, billing, and revenue cycle professionals who want a high-level view of how payment mismatch patterns vary by service type and by payer. The discussion focuses on general benchmarking, service-category comparisons, and contextual factors that may affect reported results.
Why This Topic Matters
Payment accuracy can vary by service type and by payer, which affects claim follow-up, contract analysis, and revenue cycle monitoring. This benchmark helps readers understand broad patterns in payer performance and the type of comparative data used to evaluate them.
What You Will Learn
- How payer payment accuracy is compared across service types
- How private payer performance is benchmarked against Medicare
- What broad service categories are discussed in the 2011 report card data
- Why service-type patterns matter in payer performance analysis
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle managers
- Practice administrators
- Payer contract analysts
Code Ranges Discussed
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