tci Medicare Compliance & Reimbursement - 2011 Issue 14

Industry Notes: AMA Report Card Ranks Payers, Finds 19.3 Percent Claims- Processing Error Rate

Physicians received no payment at all on nearly 23 percent of claims submitted to commercial payers. The American Medical Association (AMA) released its fourth annual National Health Insurer Report Card (NHIRC) last month, and the findings don't paint a pretty picture. According to the AMA, commercial payers show an average claims processing error rate of 19.3 percent. That represents a two percent increase over last year. "A 20 percent error rate among health insurers represents an intolerable level of inefficiency that wastes an estimated $17 billion annually," said AMA Board Member Barbara L. McAneny, M.D., in...

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