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July 12, 2010 01:00 AM

20% of medical claims processed incorrectly: AMA

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    One in five medical claims is processed incorrectly by health insurers, according to the American Medical Association in its third annual report on the topic. Health insurers had an accuracy rate for processing and paying claims of 80% overall.

    Coventry Health Care rated first in accuracy, with 88.4% of claims processed and paid correctly, out of seven major insurers measured. About $777.6 million in administrative costs could be saved by improving claims payment accuracy by 1 percentage point, the AMA estimates.

    Getting to 100% claims payment accuracy would save up to $15.5 billion, according to the AMA. “Creating a single transparent set of processing and payment rules for the health insurance industry would create systemwide savings and allow physicians to direct time and resources to patient care and away from excessive paperwork,” says Nancy Nielsen, M.D., former president of the AMA, in a written statement.

    According to a statement from America's Health Insurance Plans, “Health plans and providers share the responsibility of making the innovations and investments needed to improve efficiency in our healthcare system.” A recent AHIP survey found that “nearly one-fifth of all provider claims are not submitted to health plans electronically, and more than 1 in 5 claims are submitted by providers at least 30 days after the delivery of care.”

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      • Current News
      • Providers
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      • Safety & Quality
      • Transformation
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        • Operations
        • Care Delivery
        • Payment
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      • Regional News
        • Midwest
        • Northeast
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    • Unwell in America
    • Opinion
      • Bold Moves
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      • Letters
      • Vital Signs Blog
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Hospital at Home
        • - Workplace of the Future
        • - Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • Data Center
      • Data Center Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • MORE+
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