AMA: 20 Percent Of Medical Claims Paid Incorrectly, Wastes Billions

Main Category: Health Insurance / Medical Insurance
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Article Date: 16 Jun 2010 - 4:00 PDT

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The American Medical Association said Monday that private insurers pay 20 percent of physician claims incorrectly in its third annual 'report card' on the insurance industry, The Associated Press reports. "The AMA report card is an effort to reduce the cost of claims processing for doctors. As much as $210 billion is spent annually to process insurance claims." An insurance industry spokesperson said insurers and doctors share responsibility for ensuring accurate claims - since doctors submit them. He also said rising health costs stem from medical services, not health plans' administrative expenses (Johnson, 6/15).

Chicago Tribune: "AMA officials say insurers have improved their claims processing accuracy since the doctors' group began rating health plan business practices three years ago. The AMA report's findings are based on a random sample of about 2 million electronic claims." Making claims payments 100 percent accurate could save the health system $15 billion, the group said. The report card only focused on the seven largest insurers (Jaspen, 6/14).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.

© Henry J. Kaiser Family Foundation. All rights reserved.



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