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

Why This Topic Matters

The article highlights payer claim-processing variability, a national coverage policy update that affects treatment access, and new CMS resources that may help practices understand and participate in PQRS. These developments can affect reimbursement workflow, coverage awareness, and quality-reporting readiness.

Article Sections

1. AMA National Health Insurer Report Card findings

   Summarizes the AMA’s annual report card on commercial payer claims-processing performance. It discusses broad trends in accuracy, denials, unpaid claims, and response time among major insurers.

2. CMS coverage decision for cellular immunotherapy

   Describes a CMS national coverage update for a prostate cancer therapy and notes the change from local contractor review to broader coverage. The section focuses on the coverage policy context and the affected clinical area.

3. CMS educational resources for PQRS

   Introduces new CMS materials intended to help practices better understand PQRS reporting. It outlines the general types of educational documents and where they can be found.