decisionhealth Newsletters, Part B News - 2012 Issue 7 (July)
Benchmark of the Week: Payer performance by timeliness, claims paid $0
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Article Overview
This article reviews payer performance using two general measures: how quickly first payment is issued and how often claim lines are paid at $0. It compares Medicare with several private payers using 2012 data from the American Medical Association’s National Health Insurer Report Card, with a brief year-over-year comparison to 2011. The piece is useful for billing, revenue cycle, and payer relations teams that want a high-level view of payer responsiveness and payment outcomes.
Why This Topic Matters
Understanding payer timeliness and the frequency of $0-paid claim lines helps organizations evaluate payer behavior, anticipate cash-flow timing, and compare performance across major insurers. The article provides a concise benchmark snapshot that can support revenue cycle monitoring and payer analysis.
What You Will Learn
- How the article frames payer performance benchmarking
- Which broad payment-timeliness measures are compared
- How the article treats claim lines paid $0 as a performance metric
- What source and time period the benchmark data come from
- Which payer groups are included in the comparison
Who Should Read This
- Medical billers
- Revenue cycle managers
- Coding professionals
- Practice administrators
- Payer relations staff
- Healthcare finance teams
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