Fact Based List:

Seven Key Findings from AMA's 2011 National Health Insurer Report Card

Submitted by Clive Riddle on Tue, 06/21/2011 - 18:09

  1. Commercial health insurers have an average claims-processing error rate of 19.3 percent, an increase of two percent compared last year
  2. Physicians received no payment at all from commercial health insurers on nearly 23 percent of claims they submitted
  3. Claims response time varied for commercial health insurers from six to 15 median days
  4. UnitedHealthcare came out on top of seven leading commercial health insurers with a accuracy rating of 90.23 percent
  5. CIGNA maintained its industry leading low denial rate of .68 percent
  6. CIGNA had the highest rate of claims requiring prior authorization, with more than six percent of claims indicating physician work associated with these requirements
  7. Anthem Blue Cross Blue Shield had scored the worst of those measured with an accuracy rating of 61.05 percent

Notes: The findings from the 2011 National Health Insurer Report Card are based on a random sampling of approximately 2.4 million electronic claims for approximately 4 million medical services submitted in February and March of 2011 to Aetna, Anthem Blue Cross Blue Shield, CIGNA, Health Care Service Corporation, Humana, The Regence Group, UnitedHealthcare and Medicare. Claims were accumulated from more than 400 physician practices in 80 medical specialties providing care in 42 states.
Source: AMA Press Release: New AMA Health Insurer Report Card Finds Increasing Inaccuracy in Claims Payment
Source URL: http://www.ama-assn.org/ama/pub/news/news/ama-health-insurer...

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