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One in 10 Health Insurance Claims Processed Improperly

Source: Chicago Tribune


Posted on 19 Jun 2012 by Neilson

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Insurance claimsInsurance companies incorrectly processed about one in 10 claims in the early part of 2012, a vast improvement over the same period last year, the American Medical Association said today.

In its fifth annual National Health Insurer Report Card, the AMA said the nation's seven largest health insurers paid doctors and other providers the wrong amount 9.5 percent of the time this year, compared with 19.3 percent in 2011.

The AMA said the improvement saved health systems about $8 billion by eliminating costly administrative work.

Still, the report said, claims errors contribute to about $7 billion in wasteful spending.

"Paying medical claims accurately the first time is good business practice for insurance companies that saves precious health care dollars and frees physicians from needless administrative tasks that take time away from patient care," said Dr. Robert M. Wah, the association's board chairman.

The report measured timeliness, transparency and accuracy of medical claims processing of 1.1 million electronic claims to Aetna Inc., Humana Inc., Cigna Inc., Anthem Blue Cross Blue Shield, Regence, Medicare and Chicago-based Health Care Service Corp., the parent company of Blue Cross and Blue Shield plans in Illinois, Texas, Oklahoma and New Mexico.


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