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AMA: Insurers inaccurately process 20 percent of medical claims

Posted On Wed, June 16, 2010

One of the causes of soaring medical insurance rates may be the fault of insurance providers themselves.

About one out of every five medical claims is processed inaccurately, the American Medical Association said in its third annual medical insurance report card. AMA immediate past president Nancy Nielsen said that this highlighted an easy way for both physicians and insurers to cut administrative costs overnight.

"Creating a single transparent set of processing and payment rules for the health insurance industry would create system-wide savings," she said, adding that this would allow physicians to focus more on patient care and less on paperwork.

Even the most accurate insurer processed claims with a rating of 88.41 percent, while Anthem Blue Cross Blue Shield came in last with just 73.98 percent accuracy, the AMA said. Improving these errors by even 1 percent could save the health insurance industry about $777.6 million a year. Achieving 100 percent accuracy would save up to $15.5 billion.

A report from Marketwatch said that health insurers are working to improve their customer service as a means of increasing profit ahead of the new health insurance laws which could cut into them severely at first.ADNFCR-2297-ID-19841325-ADNFCR

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