AMA: Health Insurers Still Making Errors On Nearly 20% Of Claims Processed

Last June, when the American Medical Association announced its finding that nearly one out of every five health insurance claims had been processed incorrectly, it had probably hoped it was giving the insurance biz a much needed kick in the pants. But one year and another AMA report card later, that statistic remains virtually unchanged.

The AMA’s National Health Insurer Report Card aims to inform both the public and the health care industry about the timeliness and accuracy of claims processing.

As insurance companies continue to jack up rates on customers in order to cover growing costs, the AMA report says insurers are wasting billions by not having a better system for processing claims.

Says one AMA board member:

A 20 percent error rate among health insurers represents an intolerable level of inefficiency that wastes an estimated $17 billion annually… Health insurers must put more effort into paying claims correctly the first time to save precious health care dollars and reduce unnecessary administrative tasks that take time and resources away from patient care.

The company with the best rating for processing claims was UnitedHealth with 90.23% of claims processed accurately. The least accurate company is also the one garnering all the headlines for rate inflation, Anthem Blue Cross Blue Shield only processed 61.05% of its claims accurately.

AMA: Nearly one in five medical claims processed inaccurately[Chicago Tribune]