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Patients Shoulder Nearly 25% of Medical Bills

John Commins, for HealthLeaders Media, June 18, 2013

"In this day and age when healthcare costs are so high the AMA is focused on the idea that we need to lower the costs of healthcare without harming patients," McAneny says. "One of the ways that we can lower the cost of healthcare and actually do a better job for patients and for doctors is to eliminate this huge amount of money that goes into the administrative burden that we are trying to quantify with this index."  

McAneny says that the Health Insurer Report Card since it was first published in 2008 has provided an influential and reliable measure of payers' denials, timeliness, accuracy and transparency, and has prompted insurers to clean up their acts and honor the wording of their own contracts.  

"That's a huge benefit for physicians that I don't think a lot of physicians are even aware of. They just think their billing department is doing better at collecting claims," she says. "The fact that a lot of the insurance companies now have gone from under 80% accuracy to upward of 95% accuracy in paying claims is a huge benefit."

Other key findings highlighted in the report card:

Accuracy: Error rates for commercial health insurers on paid medical claims have dropped from nearly 20% in 2010 to 7.1% in 2013. While dramatic improvements have been made in accuracy during the last three years, the AMA estimates that more than $43 billion could have been saved if commercial insurers consistently paid claims correctly since 2010. UnitedHealthcare led commercial plans with an accuracy rating of 97.5%. Regence trailed all plans with an accuracy rating of 85%. Medicare led all insurers with an accuracy rating of 98%.

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