American Medical Association (AMA): Annual Meeting of the House of Delegates

CHICAGO – The American Medical Association’s House of Delegates passed a resolution on June 21 to "vigorously" work to change the Affordable Care Act so that the law better lines up with the organization’s policies.

The resolution that passed by a voice vote specifically addressed the need to repeal the Independent Payment Advisory Board and enact comprehensive medical liability reform and antitrust reform. Delegates such as Dr. Bruce Scott of the Kentucky delegation said that this is an effort to prove a point to the AMA members who have left the organization.

"I think that this will begin to satisfy some of the unhappy physicians back home who believe, mistakenly, that the AMA embraced wholeheartedly the [Affordable Care Act] legislation," Dr. Scott said from the house floor.

Alabama delegate Dr. Jeff Terry agreed. "I think some of us feel like perhaps some of the decisions that we’ve made through [the AMA’s] government relations [department] don’t go along with our policy, and I’d like to make an effort to try to make sure our AMA policy is what moves forward on the ACA as we attempt to change it," he said on the house floor.

Block granting in the Medicaid program also was addressed by the House of Delegates. A resolution proposed by the American Academy of Pediatrics recommended that the AMA strongly oppose block granting the Medicaid program.

Dr. Melissa Garretson, a member of the AAP delegation, spoke on the need to maintain the federal/state partnership under Medicaid so that recipients can be ensured of basic benefits no matter where in the United States they live.

"Right now, what this language says is that the state gets to decide," said Dr. Garretson of Fort Worth, Tex. "Well, I live in that state where they could give a you-know-what about the 1.1 million uninsured kids and they don’t want to do anything with Medicaid. That’s just not where they are."

Dr. Marion Burton, also an AAP delegate, agreed. "For the AMA to go on record as supporting block grants would cause millions of children to be thrown under the uninsured bus," he said.

The resolution was referred to the board of trustees for a later decision.

CHICAGO – The American Medical Association’s House of Delegates passed a resolution on June 21 to "vigorously" work to change the Affordable Care Act so that the law better lines up with the organization’s policies.

The resolution that passed by a voice vote specifically addressed the need to repeal the Independent Payment Advisory Board and enact comprehensive medical liability reform and antitrust reform. Delegates such as Dr. Bruce Scott of the Kentucky delegation said that this is an effort to prove a point to the AMA members who have left the organization.

"I think that this will begin to satisfy some of the unhappy physicians back home who believe, mistakenly, that the AMA embraced wholeheartedly the [Affordable Care Act] legislation," Dr. Scott said from the house floor.

Alabama delegate Dr. Jeff Terry agreed. "I think some of us feel like perhaps some of the decisions that we’ve made through [the AMA’s] government relations [department] don’t go along with our policy, and I’d like to make an effort to try to make sure our AMA policy is what moves forward on the ACA as we attempt to change it," he said on the house floor.

Block granting in the Medicaid program also was addressed by the House of Delegates. A resolution proposed by the American Academy of Pediatrics recommended that the AMA strongly oppose block granting the Medicaid program.

Dr. Melissa Garretson, a member of the AAP delegation, spoke on the need to maintain the federal/state partnership under Medicaid so that recipients can be ensured of basic benefits no matter where in the United States they live.

"Right now, what this language says is that the state gets to decide," said Dr. Garretson of Fort Worth, Tex. "Well, I live in that state where they could give a you-know-what about the 1.1 million uninsured kids and they don’t want to do anything with Medicaid. That’s just not where they are."

Dr. Marion Burton, also an AAP delegate, agreed. "For the AMA to go on record as supporting block grants would cause millions of children to be thrown under the uninsured bus," he said.

The resolution was referred to the board of trustees for a later decision.

CHICAGO – The American Medical Association’s House of Delegates passed a resolution on June 21 to "vigorously" work to change the Affordable Care Act so that the law better lines up with the organization’s policies.

The resolution that passed by a voice vote specifically addressed the need to repeal the Independent Payment Advisory Board and enact comprehensive medical liability reform and antitrust reform. Delegates such as Dr. Bruce Scott of the Kentucky delegation said that this is an effort to prove a point to the AMA members who have left the organization.

"I think that this will begin to satisfy some of the unhappy physicians back home who believe, mistakenly, that the AMA embraced wholeheartedly the [Affordable Care Act] legislation," Dr. Scott said from the house floor.

Alabama delegate Dr. Jeff Terry agreed. "I think some of us feel like perhaps some of the decisions that we’ve made through [the AMA’s] government relations [department] don’t go along with our policy, and I’d like to make an effort to try to make sure our AMA policy is what moves forward on the ACA as we attempt to change it," he said on the house floor.

Block granting in the Medicaid program also was addressed by the House of Delegates. A resolution proposed by the American Academy of Pediatrics recommended that the AMA strongly oppose block granting the Medicaid program.

Dr. Melissa Garretson, a member of the AAP delegation, spoke on the need to maintain the federal/state partnership under Medicaid so that recipients can be ensured of basic benefits no matter where in the United States they live.

"Right now, what this language says is that the state gets to decide," said Dr. Garretson of Fort Worth, Tex. "Well, I live in that state where they could give a you-know-what about the 1.1 million uninsured kids and they don’t want to do anything with Medicaid. That’s just not where they are."

Dr. Marion Burton, also an AAP delegate, agreed. "For the AMA to go on record as supporting block grants would cause millions of children to be thrown under the uninsured bus," he said.

The resolution was referred to the board of trustees for a later decision.

CHICAGO – The American Medical Association’s House of Delegates passed a resolution on June 21 to "vigorously" work to change the Affordable Care Act so that the law better lines up with the organization’s policies.

The resolution that passed by a voice vote specifically addressed the need to repeal the Independent Payment Advisory Board and enact comprehensive medical liability reform and antitrust reform. Delegates such as Dr. Bruce Scott of the Kentucky delegation said that this is an effort to prove a point to the AMA members who have left the organization.

"I think that this will begin to satisfy some of the unhappy physicians back home who believe, mistakenly, that the AMA embraced wholeheartedly the [Affordable Care Act] legislation," Dr. Scott said from the house floor.

Alabama delegate Dr. Jeff Terry agreed. "I think some of us feel like perhaps some of the decisions that we’ve made through [the AMA’s] government relations [department] don’t go along with our policy, and I’d like to make an effort to try to make sure our AMA policy is what moves forward on the ACA as we attempt to change it," he said on the house floor.

Block granting in the Medicaid program also was addressed by the House of Delegates. A resolution proposed by the American Academy of Pediatrics recommended that the AMA strongly oppose block granting the Medicaid program.

Dr. Melissa Garretson, a member of the AAP delegation, spoke on the need to maintain the federal/state partnership under Medicaid so that recipients can be ensured of basic benefits no matter where in the United States they live.

"Right now, what this language says is that the state gets to decide," said Dr. Garretson of Fort Worth, Tex. "Well, I live in that state where they could give a you-know-what about the 1.1 million uninsured kids and they don’t want to do anything with Medicaid. That’s just not where they are."

Dr. Marion Burton, also an AAP delegate, agreed. "For the AMA to go on record as supporting block grants would cause millions of children to be thrown under the uninsured bus," he said.

The resolution was referred to the board of trustees for a later decision.

CHICAGO – The American Medical Association’s House of Delegates passed a resolution on June 21 to "vigorously" work to change the Affordable Care Act so that the law better lines up with the organization’s policies.

The resolution that passed by a voice vote specifically addressed the need to repeal the Independent Payment Advisory Board and enact comprehensive medical liability reform and antitrust reform. Delegates such as Dr. Bruce Scott of the Kentucky delegation said that this is an effort to prove a point to the AMA members who have left the organization.

"I think that this will begin to satisfy some of the unhappy physicians back home who believe, mistakenly, that the AMA embraced wholeheartedly the [Affordable Care Act] legislation," Dr. Scott said from the house floor.

Alabama delegate Dr. Jeff Terry agreed. "I think some of us feel like perhaps some of the decisions that we’ve made through [the AMA’s] government relations [department] don’t go along with our policy, and I’d like to make an effort to try to make sure our AMA policy is what moves forward on the ACA as we attempt to change it," he said on the house floor.

Block granting in the Medicaid program also was addressed by the House of Delegates. A resolution proposed by the American Academy of Pediatrics recommended that the AMA strongly oppose block granting the Medicaid program.

Dr. Melissa Garretson, a member of the AAP delegation, spoke on the need to maintain the federal/state partnership under Medicaid so that recipients can be ensured of basic benefits no matter where in the United States they live.

"Right now, what this language says is that the state gets to decide," said Dr. Garretson of Fort Worth, Tex. "Well, I live in that state where they could give a you-know-what about the 1.1 million uninsured kids and they don’t want to do anything with Medicaid. That’s just not where they are."

Dr. Marion Burton, also an AAP delegate, agreed. "For the AMA to go on record as supporting block grants would cause millions of children to be thrown under the uninsured bus," he said.

The resolution was referred to the board of trustees for a later decision.

CHICAGO – The American Medical Association’s House of Delegates passed a resolution on June 21 to "vigorously" work to change the Affordable Care Act so that the law better lines up with the organization’s policies.

The resolution that passed by a voice vote specifically addressed the need to repeal the Independent Payment Advisory Board and enact comprehensive medical liability reform and antitrust reform. Delegates such as Dr. Bruce Scott of the Kentucky delegation said that this is an effort to prove a point to the AMA members who have left the organization.

"I think that this will begin to satisfy some of the unhappy physicians back home who believe, mistakenly, that the AMA embraced wholeheartedly the [Affordable Care Act] legislation," Dr. Scott said from the house floor.

Alabama delegate Dr. Jeff Terry agreed. "I think some of us feel like perhaps some of the decisions that we’ve made through [the AMA’s] government relations [department] don’t go along with our policy, and I’d like to make an effort to try to make sure our AMA policy is what moves forward on the ACA as we attempt to change it," he said on the house floor.

Block granting in the Medicaid program also was addressed by the House of Delegates. A resolution proposed by the American Academy of Pediatrics recommended that the AMA strongly oppose block granting the Medicaid program.

Dr. Melissa Garretson, a member of the AAP delegation, spoke on the need to maintain the federal/state partnership under Medicaid so that recipients can be ensured of basic benefits no matter where in the United States they live.

"Right now, what this language says is that the state gets to decide," said Dr. Garretson of Fort Worth, Tex. "Well, I live in that state where they could give a you-know-what about the 1.1 million uninsured kids and they don’t want to do anything with Medicaid. That’s just not where they are."

Dr. Marion Burton, also an AAP delegate, agreed. "For the AMA to go on record as supporting block grants would cause millions of children to be thrown under the uninsured bus," he said.

The resolution was referred to the board of trustees for a later decision.

The American Medical Association's House of Delegates meeting wrapped up on Tuesday, June 21, a day ahead of schedule. The delegates touched on a wide range of issues over 4 days at the Hyatt Regency in Chicago. None was more hotly debated than whether the AMA should back the so-called individual mandate that's a central tenet of the Affordable Care Act.

Photo credit: Alicia Ault

While much time and energy was devoted to that topic, delegates also discussed many public health, practice management and payment issues. 

The nation's obesity epidemic was addressed in many resolutions. Pediatricians and medical students pushed for having the AMA take a strong stand on fast food, competitive eating, and physical education.

For that and more, listen to this special installment of the Policy & Practice Podcast:

The American Medical Association's House of Delegates meeting wrapped up on Tuesday, June 21, a day ahead of schedule. The delegates touched on a wide range of issues over 4 days at the Hyatt Regency in Chicago. None was more hotly debated than whether the AMA should back the so-called individual mandate that's a central tenet of the Affordable Care Act.

Photo credit: Alicia Ault

While much time and energy was devoted to that topic, delegates also discussed many public health, practice management and payment issues. 

The nation's obesity epidemic was addressed in many resolutions. Pediatricians and medical students pushed for having the AMA take a strong stand on fast food, competitive eating, and physical education.

For that and more, listen to this special installment of the Policy & Practice Podcast:

The American Medical Association's House of Delegates meeting wrapped up on Tuesday, June 21, a day ahead of schedule. The delegates touched on a wide range of issues over 4 days at the Hyatt Regency in Chicago. None was more hotly debated than whether the AMA should back the so-called individual mandate that's a central tenet of the Affordable Care Act.

Photo credit: Alicia Ault

While much time and energy was devoted to that topic, delegates also discussed many public health, practice management and payment issues. 

The nation's obesity epidemic was addressed in many resolutions. Pediatricians and medical students pushed for having the AMA take a strong stand on fast food, competitive eating, and physical education.

For that and more, listen to this special installment of the Policy & Practice Podcast:

CHICAGO – A sampling of claims payments from some of the nation’s top insurers shows that although they are paying much more quickly, some 23% of claims were denied and almost a fifth were paid incorrectly.

The study was conducted for the American Medical Association and issued June 20 at the organization’s annual House of Delegates meeting.

The 2011 National Health Insurer Report Card showed that the error rate of 19.3% represented an extra $3.6 million in erroneous claims, a 2% increase from the previous year. The AMA estimated that these faulty payouts and the hassles associated with them added $1.5 billion in administrative costs to the health care system.

"This report card conveys that the current state of the health care claims process is untenable," AMA board member Dr. Barbara L. McAneny said at the annual meeting of the AMA’s House of Delegates.

She said that 10%-14% of a physician’s revenue goes to dealing with administrative issues. The AMA is working with insurers and physicians to get that down to 1% of revenue.

The report card tracked a number of performance measures at Medicare and seven private insurers: Aetna, Anthem Blue Cross/Blue Shield, Cigna, Health Care Services Corp., Humana, Regence, and UnitedHealthcare.

UnitedHealthcare was the only insurer that improved its claims-processing accuracy from 2010, paying 90% of claims in an accurate manner. Anthem, on the other hand, paid only 61% of claims accurately.

The outright denial rate (in which no payment is made) ranged from a low of 17% of claims at Regence to 25% at Anthem and Cigna.

Prior authorization is a growing problem for physicians and constitutes one of the top eight reasons for denial of claims, according to Mark Rieger, CEO of National Healthcare Exchange Services, the company that conducted the analysis for the AMA. Coping with prior authorization is the second-largest administrative task for physicians, consuming at least 20 hours a week of physician and staff time, he said at the meeting.

Cigna had highest rate (6%) of claims requiring prior authorization; Regence had the lowest (0.04%).

There were some bright spots in the report. The vast majority of claims are now being paid within the first 15 days, with the remainder coming largely within 16-30 days of submission. Humana and Medicare were the fastest, paying some 95% of claims within 15 days. Cigna and Health Care Services Corp. were close behind.

The data were compiled by National Healthcare Exchange Services. The company analyzed claims submitted between Feb. 1 and March 31, 2011. Claims came from 42 states and included 4 million services billed on 2.4 million claims made by 400 practices covering 80 specialties.

CHICAGO – A sampling of claims payments from some of the nation’s top insurers shows that although they are paying much more quickly, some 23% of claims were denied and almost a fifth were paid incorrectly.

The study was conducted for the American Medical Association and issued June 20 at the organization’s annual House of Delegates meeting.

The 2011 National Health Insurer Report Card showed that the error rate of 19.3% represented an extra $3.6 million in erroneous claims, a 2% increase from the previous year. The AMA estimated that these faulty payouts and the hassles associated with them added $1.5 billion in administrative costs to the health care system.

"This report card conveys that the current state of the health care claims process is untenable," AMA board member Dr. Barbara L. McAneny said at the annual meeting of the AMA’s House of Delegates.

She said that 10%-14% of a physician’s revenue goes to dealing with administrative issues. The AMA is working with insurers and physicians to get that down to 1% of revenue.

The report card tracked a number of performance measures at Medicare and seven private insurers: Aetna, Anthem Blue Cross/Blue Shield, Cigna, Health Care Services Corp., Humana, Regence, and UnitedHealthcare.

UnitedHealthcare was the only insurer that improved its claims-processing accuracy from 2010, paying 90% of claims in an accurate manner. Anthem, on the other hand, paid only 61% of claims accurately.

The outright denial rate (in which no payment is made) ranged from a low of 17% of claims at Regence to 25% at Anthem and Cigna.

Prior authorization is a growing problem for physicians and constitutes one of the top eight reasons for denial of claims, according to Mark Rieger, CEO of National Healthcare Exchange Services, the company that conducted the analysis for the AMA. Coping with prior authorization is the second-largest administrative task for physicians, consuming at least 20 hours a week of physician and staff time, he said at the meeting.

Cigna had highest rate (6%) of claims requiring prior authorization; Regence had the lowest (0.04%).

There were some bright spots in the report. The vast majority of claims are now being paid within the first 15 days, with the remainder coming largely within 16-30 days of submission. Humana and Medicare were the fastest, paying some 95% of claims within 15 days. Cigna and Health Care Services Corp. were close behind.

The data were compiled by National Healthcare Exchange Services. The company analyzed claims submitted between Feb. 1 and March 31, 2011. Claims came from 42 states and included 4 million services billed on 2.4 million claims made by 400 practices covering 80 specialties.

CHICAGO – A sampling of claims payments from some of the nation’s top insurers shows that although they are paying much more quickly, some 23% of claims were denied and almost a fifth were paid incorrectly.

The study was conducted for the American Medical Association and issued June 20 at the organization’s annual House of Delegates meeting.

The 2011 National Health Insurer Report Card showed that the error rate of 19.3% represented an extra $3.6 million in erroneous claims, a 2% increase from the previous year. The AMA estimated that these faulty payouts and the hassles associated with them added $1.5 billion in administrative costs to the health care system.

"This report card conveys that the current state of the health care claims process is untenable," AMA board member Dr. Barbara L. McAneny said at the annual meeting of the AMA’s House of Delegates.

She said that 10%-14% of a physician’s revenue goes to dealing with administrative issues. The AMA is working with insurers and physicians to get that down to 1% of revenue.

The report card tracked a number of performance measures at Medicare and seven private insurers: Aetna, Anthem Blue Cross/Blue Shield, Cigna, Health Care Services Corp., Humana, Regence, and UnitedHealthcare.

UnitedHealthcare was the only insurer that improved its claims-processing accuracy from 2010, paying 90% of claims in an accurate manner. Anthem, on the other hand, paid only 61% of claims accurately.

The outright denial rate (in which no payment is made) ranged from a low of 17% of claims at Regence to 25% at Anthem and Cigna.

Prior authorization is a growing problem for physicians and constitutes one of the top eight reasons for denial of claims, according to Mark Rieger, CEO of National Healthcare Exchange Services, the company that conducted the analysis for the AMA. Coping with prior authorization is the second-largest administrative task for physicians, consuming at least 20 hours a week of physician and staff time, he said at the meeting.

Cigna had highest rate (6%) of claims requiring prior authorization; Regence had the lowest (0.04%).

There were some bright spots in the report. The vast majority of claims are now being paid within the first 15 days, with the remainder coming largely within 16-30 days of submission. Humana and Medicare were the fastest, paying some 95% of claims within 15 days. Cigna and Health Care Services Corp. were close behind.

The data were compiled by National Healthcare Exchange Services. The company analyzed claims submitted between Feb. 1 and March 31, 2011. Claims came from 42 states and included 4 million services billed on 2.4 million claims made by 400 practices covering 80 specialties.

CHICAGO – A sampling of claims payments from some of the nation’s top insurers shows that although they are paying much more quickly, some 23% of claims were denied and almost a fifth were paid incorrectly.

The study was conducted for the American Medical Association and issued June 20 at the organization’s annual House of Delegates meeting.

The 2011 National Health Insurer Report Card showed that the error rate of 19.3% represented an extra $3.6 million in erroneous claims, a 2% increase from the previous year. The AMA estimated that these faulty payouts and the hassles associated with them added $1.5 billion in administrative costs to the health care system.

"This report card conveys that the current state of the health care claims process is untenable," AMA board member Dr. Barbara L. McAneny said at the annual meeting of the AMA’s House of Delegates.

She said that 10%-14% of a physician’s revenue goes to dealing with administrative issues. The AMA is working with insurers and physicians to get that down to 1% of revenue.

The report card tracked a number of performance measures at Medicare and seven private insurers: Aetna, Anthem Blue Cross/Blue Shield, Cigna, Health Care Services Corp., Humana, Regence, and UnitedHealthcare.

UnitedHealthcare was the only insurer that improved its claims-processing accuracy from 2010, paying 90% of claims in an accurate manner. Anthem, on the other hand, paid only 61% of claims accurately.

The outright denial rate (in which no payment is made) ranged from a low of 17% of claims at Regence to 25% at Anthem and Cigna.

Prior authorization is a growing problem for physicians and constitutes one of the top eight reasons for denial of claims, according to Mark Rieger, CEO of National Healthcare Exchange Services, the company that conducted the analysis for the AMA. Coping with prior authorization is the second-largest administrative task for physicians, consuming at least 20 hours a week of physician and staff time, he said at the meeting.

Cigna had highest rate (6%) of claims requiring prior authorization; Regence had the lowest (0.04%).

There were some bright spots in the report. The vast majority of claims are now being paid within the first 15 days, with the remainder coming largely within 16-30 days of submission. Humana and Medicare were the fastest, paying some 95% of claims within 15 days. Cigna and Health Care Services Corp. were close behind.

The data were compiled by National Healthcare Exchange Services. The company analyzed claims submitted between Feb. 1 and March 31, 2011. Claims came from 42 states and included 4 million services billed on 2.4 million claims made by 400 practices covering 80 specialties.

CHICAGO – A sampling of claims payments from some of the nation’s top insurers shows that although they are paying much more quickly, some 23% of claims were denied and almost a fifth were paid incorrectly.

The study was conducted for the American Medical Association and issued June 20 at the organization’s annual House of Delegates meeting.

The 2011 National Health Insurer Report Card showed that the error rate of 19.3% represented an extra $3.6 million in erroneous claims, a 2% increase from the previous year. The AMA estimated that these faulty payouts and the hassles associated with them added $1.5 billion in administrative costs to the health care system.

"This report card conveys that the current state of the health care claims process is untenable," AMA board member Dr. Barbara L. McAneny said at the annual meeting of the AMA’s House of Delegates.

She said that 10%-14% of a physician’s revenue goes to dealing with administrative issues. The AMA is working with insurers and physicians to get that down to 1% of revenue.

The report card tracked a number of performance measures at Medicare and seven private insurers: Aetna, Anthem Blue Cross/Blue Shield, Cigna, Health Care Services Corp., Humana, Regence, and UnitedHealthcare.

UnitedHealthcare was the only insurer that improved its claims-processing accuracy from 2010, paying 90% of claims in an accurate manner. Anthem, on the other hand, paid only 61% of claims accurately.

The outright denial rate (in which no payment is made) ranged from a low of 17% of claims at Regence to 25% at Anthem and Cigna.

Prior authorization is a growing problem for physicians and constitutes one of the top eight reasons for denial of claims, according to Mark Rieger, CEO of National Healthcare Exchange Services, the company that conducted the analysis for the AMA. Coping with prior authorization is the second-largest administrative task for physicians, consuming at least 20 hours a week of physician and staff time, he said at the meeting.

Cigna had highest rate (6%) of claims requiring prior authorization; Regence had the lowest (0.04%).

There were some bright spots in the report. The vast majority of claims are now being paid within the first 15 days, with the remainder coming largely within 16-30 days of submission. Humana and Medicare were the fastest, paying some 95% of claims within 15 days. Cigna and Health Care Services Corp. were close behind.

The data were compiled by National Healthcare Exchange Services. The company analyzed claims submitted between Feb. 1 and March 31, 2011. Claims came from 42 states and included 4 million services billed on 2.4 million claims made by 400 practices covering 80 specialties.

CHICAGO – A sampling of claims payments from some of the nation’s top insurers shows that although they are paying much more quickly, some 23% of claims were denied and almost a fifth were paid incorrectly.

The study was conducted for the American Medical Association and issued June 20 at the organization’s annual House of Delegates meeting.

The 2011 National Health Insurer Report Card showed that the error rate of 19.3% represented an extra $3.6 million in erroneous claims, a 2% increase from the previous year. The AMA estimated that these faulty payouts and the hassles associated with them added $1.5 billion in administrative costs to the health care system.

"This report card conveys that the current state of the health care claims process is untenable," AMA board member Dr. Barbara L. McAneny said at the annual meeting of the AMA’s House of Delegates.

She said that 10%-14% of a physician’s revenue goes to dealing with administrative issues. The AMA is working with insurers and physicians to get that down to 1% of revenue.

The report card tracked a number of performance measures at Medicare and seven private insurers: Aetna, Anthem Blue Cross/Blue Shield, Cigna, Health Care Services Corp., Humana, Regence, and UnitedHealthcare.

UnitedHealthcare was the only insurer that improved its claims-processing accuracy from 2010, paying 90% of claims in an accurate manner. Anthem, on the other hand, paid only 61% of claims accurately.

The outright denial rate (in which no payment is made) ranged from a low of 17% of claims at Regence to 25% at Anthem and Cigna.

Prior authorization is a growing problem for physicians and constitutes one of the top eight reasons for denial of claims, according to Mark Rieger, CEO of National Healthcare Exchange Services, the company that conducted the analysis for the AMA. Coping with prior authorization is the second-largest administrative task for physicians, consuming at least 20 hours a week of physician and staff time, he said at the meeting.

Cigna had highest rate (6%) of claims requiring prior authorization; Regence had the lowest (0.04%).

There were some bright spots in the report. The vast majority of claims are now being paid within the first 15 days, with the remainder coming largely within 16-30 days of submission. Humana and Medicare were the fastest, paying some 95% of claims within 15 days. Cigna and Health Care Services Corp. were close behind.

The data were compiled by National Healthcare Exchange Services. The company analyzed claims submitted between Feb. 1 and March 31, 2011. Claims came from 42 states and included 4 million services billed on 2.4 million claims made by 400 practices covering 80 specialties.

CHICAGO – A sampling of claims payments from some of the nation’s top insurers shows that although they are paying much more quickly, some 23% of claims were denied and almost a fifth were paid incorrectly.

The study was conducted for the American Medical Association and issued June 20 at the organization’s annual House of Delegates meeting.

The 2011 National Health Insurer Report Card showed that the error rate of 19.3% represented an extra $3.6 million in erroneous claims, a 2% increase from the previous year. The AMA estimated that these faulty payouts and the hassles associated with them added $1.5 billion in administrative costs to the health care system.

"This report card conveys that the current state of the health care claims process is untenable," AMA board member Dr. Barbara L. McAneny said at the annual meeting of the AMA’s House of Delegates.

She said that 10%-14% of a physician’s revenue goes to dealing with administrative issues. The AMA is working with insurers and physicians to get that down to 1% of revenue.

The report card tracked a number of performance measures at Medicare and seven private insurers: Aetna, Anthem Blue Cross/Blue Shield, Cigna, Health Care Services Corp., Humana, Regence, and UnitedHealthcare.

UnitedHealthcare was the only insurer that improved its claims-processing accuracy from 2010, paying 90% of claims in an accurate manner. Anthem, on the other hand, paid only 61% of claims accurately.

The outright denial rate (in which no payment is made) ranged from a low of 17% of claims at Regence to 25% at Anthem and Cigna.

Prior authorization is a growing problem for physicians and constitutes one of the top eight reasons for denial of claims, according to Mark Rieger, CEO of National Healthcare Exchange Services, the company that conducted the analysis for the AMA. Coping with prior authorization is the second-largest administrative task for physicians, consuming at least 20 hours a week of physician and staff time, he said at the meeting.

Cigna had highest rate (6%) of claims requiring prior authorization; Regence had the lowest (0.04%).

There were some bright spots in the report. The vast majority of claims are now being paid within the first 15 days, with the remainder coming largely within 16-30 days of submission. Humana and Medicare were the fastest, paying some 95% of claims within 15 days. Cigna and Health Care Services Corp. were close behind.

The data were compiled by National Healthcare Exchange Services. The company analyzed claims submitted between Feb. 1 and March 31, 2011. Claims came from 42 states and included 4 million services billed on 2.4 million claims made by 400 practices covering 80 specialties.

CHICAGO – A sampling of claims payments from some of the nation’s top insurers shows that although they are paying much more quickly, some 23% of claims were denied and almost a fifth were paid incorrectly.

The study was conducted for the American Medical Association and issued June 20 at the organization’s annual House of Delegates meeting.

The 2011 National Health Insurer Report Card showed that the error rate of 19.3% represented an extra $3.6 million in erroneous claims, a 2% increase from the previous year. The AMA estimated that these faulty payouts and the hassles associated with them added $1.5 billion in administrative costs to the health care system.

"This report card conveys that the current state of the health care claims process is untenable," AMA board member Dr. Barbara L. McAneny said at the annual meeting of the AMA’s House of Delegates.

She said that 10%-14% of a physician’s revenue goes to dealing with administrative issues. The AMA is working with insurers and physicians to get that down to 1% of revenue.

The report card tracked a number of performance measures at Medicare and seven private insurers: Aetna, Anthem Blue Cross/Blue Shield, Cigna, Health Care Services Corp., Humana, Regence, and UnitedHealthcare.

UnitedHealthcare was the only insurer that improved its claims-processing accuracy from 2010, paying 90% of claims in an accurate manner. Anthem, on the other hand, paid only 61% of claims accurately.

The outright denial rate (in which no payment is made) ranged from a low of 17% of claims at Regence to 25% at Anthem and Cigna.

Prior authorization is a growing problem for physicians and constitutes one of the top eight reasons for denial of claims, according to Mark Rieger, CEO of National Healthcare Exchange Services, the company that conducted the analysis for the AMA. Coping with prior authorization is the second-largest administrative task for physicians, consuming at least 20 hours a week of physician and staff time, he said at the meeting.

Cigna had highest rate (6%) of claims requiring prior authorization; Regence had the lowest (0.04%).

There were some bright spots in the report. The vast majority of claims are now being paid within the first 15 days, with the remainder coming largely within 16-30 days of submission. Humana and Medicare were the fastest, paying some 95% of claims within 15 days. Cigna and Health Care Services Corp. were close behind.

The data were compiled by National Healthcare Exchange Services. The company analyzed claims submitted between Feb. 1 and March 31, 2011. Claims came from 42 states and included 4 million services billed on 2.4 million claims made by 400 practices covering 80 specialties.

CHICAGO – A sampling of claims payments from some of the nation’s top insurers shows that although they are paying much more quickly, some 23% of claims were denied and almost a fifth were paid incorrectly.

The study was conducted for the American Medical Association and issued June 20 at the organization’s annual House of Delegates meeting.

The 2011 National Health Insurer Report Card showed that the error rate of 19.3% represented an extra $3.6 million in erroneous claims, a 2% increase from the previous year. The AMA estimated that these faulty payouts and the hassles associated with them added $1.5 billion in administrative costs to the health care system.

"This report card conveys that the current state of the health care claims process is untenable," AMA board member Dr. Barbara L. McAneny said at the annual meeting of the AMA’s House of Delegates.

She said that 10%-14% of a physician’s revenue goes to dealing with administrative issues. The AMA is working with insurers and physicians to get that down to 1% of revenue.

The report card tracked a number of performance measures at Medicare and seven private insurers: Aetna, Anthem Blue Cross/Blue Shield, Cigna, Health Care Services Corp., Humana, Regence, and UnitedHealthcare.

UnitedHealthcare was the only insurer that improved its claims-processing accuracy from 2010, paying 90% of claims in an accurate manner. Anthem, on the other hand, paid only 61% of claims accurately.

The outright denial rate (in which no payment is made) ranged from a low of 17% of claims at Regence to 25% at Anthem and Cigna.

Prior authorization is a growing problem for physicians and constitutes one of the top eight reasons for denial of claims, according to Mark Rieger, CEO of National Healthcare Exchange Services, the company that conducted the analysis for the AMA. Coping with prior authorization is the second-largest administrative task for physicians, consuming at least 20 hours a week of physician and staff time, he said at the meeting.

Cigna had highest rate (6%) of claims requiring prior authorization; Regence had the lowest (0.04%).

There were some bright spots in the report. The vast majority of claims are now being paid within the first 15 days, with the remainder coming largely within 16-30 days of submission. Humana and Medicare were the fastest, paying some 95% of claims within 15 days. Cigna and Health Care Services Corp. were close behind.

The data were compiled by National Healthcare Exchange Services. The company analyzed claims submitted between Feb. 1 and March 31, 2011. Claims came from 42 states and included 4 million services billed on 2.4 million claims made by 400 practices covering 80 specialties.

CHICAGO – A sampling of claims payments from some of the nation’s top insurers shows that although they are paying much more quickly, some 23% of claims were denied and almost a fifth were paid incorrectly.

The study was conducted for the American Medical Association and issued June 20 at the organization’s annual House of Delegates meeting.

The 2011 National Health Insurer Report Card showed that the error rate of 19.3% represented an extra $3.6 million in erroneous claims, a 2% increase from the previous year. The AMA estimated that these faulty payouts and the hassles associated with them added $1.5 billion in administrative costs to the health care system.

"This report card conveys that the current state of the health care claims process is untenable," AMA board member Dr. Barbara L. McAneny said at the annual meeting of the AMA’s House of Delegates.

She said that 10%-14% of a physician’s revenue goes to dealing with administrative issues. The AMA is working with insurers and physicians to get that down to 1% of revenue.

The report card tracked a number of performance measures at Medicare and seven private insurers: Aetna, Anthem Blue Cross/Blue Shield, Cigna, Health Care Services Corp., Humana, Regence, and UnitedHealthcare.

UnitedHealthcare was the only insurer that improved its claims-processing accuracy from 2010, paying 90% of claims in an accurate manner. Anthem, on the other hand, paid only 61% of claims accurately.

The outright denial rate (in which no payment is made) ranged from a low of 17% of claims at Regence to 25% at Anthem and Cigna.

Prior authorization is a growing problem for physicians and constitutes one of the top eight reasons for denial of claims, according to Mark Rieger, CEO of National Healthcare Exchange Services, the company that conducted the analysis for the AMA. Coping with prior authorization is the second-largest administrative task for physicians, consuming at least 20 hours a week of physician and staff time, he said at the meeting.

Cigna had highest rate (6%) of claims requiring prior authorization; Regence had the lowest (0.04%).

There were some bright spots in the report. The vast majority of claims are now being paid within the first 15 days, with the remainder coming largely within 16-30 days of submission. Humana and Medicare were the fastest, paying some 95% of claims within 15 days. Cigna and Health Care Services Corp. were close behind.

The data were compiled by National Healthcare Exchange Services. The company analyzed claims submitted between Feb. 1 and March 31, 2011. Claims came from 42 states and included 4 million services billed on 2.4 million claims made by 400 practices covering 80 specialties.

CHICAGO – A sampling of claims payments from some of the nation’s top insurers shows that although they are paying much more quickly, some 23% of claims were denied and almost a fifth were paid incorrectly.

The study was conducted for the American Medical Association and issued June 20 at the organization’s annual House of Delegates meeting.

The 2011 National Health Insurer Report Card showed that the error rate of 19.3% represented an extra $3.6 million in erroneous claims, a 2% increase from the previous year. The AMA estimated that these faulty payouts and the hassles associated with them added $1.5 billion in administrative costs to the health care system.

"This report card conveys that the current state of the health care claims process is untenable," AMA board member Dr. Barbara L. McAneny said at the annual meeting of the AMA’s House of Delegates.

She said that 10%-14% of a physician’s revenue goes to dealing with administrative issues. The AMA is working with insurers and physicians to get that down to 1% of revenue.

The report card tracked a number of performance measures at Medicare and seven private insurers: Aetna, Anthem Blue Cross/Blue Shield, Cigna, Health Care Services Corp., Humana, Regence, and UnitedHealthcare.

UnitedHealthcare was the only insurer that improved its claims-processing accuracy from 2010, paying 90% of claims in an accurate manner. Anthem, on the other hand, paid only 61% of claims accurately.

The outright denial rate (in which no payment is made) ranged from a low of 17% of claims at Regence to 25% at Anthem and Cigna.

Prior authorization is a growing problem for physicians and constitutes one of the top eight reasons for denial of claims, according to Mark Rieger, CEO of National Healthcare Exchange Services, the company that conducted the analysis for the AMA. Coping with prior authorization is the second-largest administrative task for physicians, consuming at least 20 hours a week of physician and staff time, he said at the meeting.

Cigna had highest rate (6%) of claims requiring prior authorization; Regence had the lowest (0.04%).

There were some bright spots in the report. The vast majority of claims are now being paid within the first 15 days, with the remainder coming largely within 16-30 days of submission. Humana and Medicare were the fastest, paying some 95% of claims within 15 days. Cigna and Health Care Services Corp. were close behind.

The data were compiled by National Healthcare Exchange Services. The company analyzed claims submitted between Feb. 1 and March 31, 2011. Claims came from 42 states and included 4 million services billed on 2.4 million claims made by 400 practices covering 80 specialties.

CHICAGO – A sampling of claims payments from some of the nation’s top insurers shows that although they are paying much more quickly, some 23% of claims were denied and almost a fifth were paid incorrectly.

The study was conducted for the American Medical Association and issued June 20 at the organization’s annual House of Delegates meeting.

The 2011 National Health Insurer Report Card showed that the error rate of 19.3% represented an extra $3.6 million in erroneous claims, a 2% increase from the previous year. The AMA estimated that these faulty payouts and the hassles associated with them added $1.5 billion in administrative costs to the health care system.

"This report card conveys that the current state of the health care claims process is untenable," AMA board member Dr. Barbara L. McAneny said at the annual meeting of the AMA’s House of Delegates.

She said that 10%-14% of a physician’s revenue goes to dealing with administrative issues. The AMA is working with insurers and physicians to get that down to 1% of revenue.

The report card tracked a number of performance measures at Medicare and seven private insurers: Aetna, Anthem Blue Cross/Blue Shield, Cigna, Health Care Services Corp., Humana, Regence, and UnitedHealthcare.

UnitedHealthcare was the only insurer that improved its claims-processing accuracy from 2010, paying 90% of claims in an accurate manner. Anthem, on the other hand, paid only 61% of claims accurately.

The outright denial rate (in which no payment is made) ranged from a low of 17% of claims at Regence to 25% at Anthem and Cigna.

Prior authorization is a growing problem for physicians and constitutes one of the top eight reasons for denial of claims, according to Mark Rieger, CEO of National Healthcare Exchange Services, the company that conducted the analysis for the AMA. Coping with prior authorization is the second-largest administrative task for physicians, consuming at least 20 hours a week of physician and staff time, he said at the meeting.

Cigna had highest rate (6%) of claims requiring prior authorization; Regence had the lowest (0.04%).

There were some bright spots in the report. The vast majority of claims are now being paid within the first 15 days, with the remainder coming largely within 16-30 days of submission. Humana and Medicare were the fastest, paying some 95% of claims within 15 days. Cigna and Health Care Services Corp. were close behind.

The data were compiled by National Healthcare Exchange Services. The company analyzed claims submitted between Feb. 1 and March 31, 2011. Claims came from 42 states and included 4 million services billed on 2.4 million claims made by 400 practices covering 80 specialties.

CHICAGO – A sampling of claims payments from some of the nation’s top insurers shows that although they are paying much more quickly, some 23% of claims were denied and almost a fifth were paid incorrectly.

The study was conducted for the American Medical Association and issued June 20 at the organization’s annual House of Delegates meeting.

The 2011 National Health Insurer Report Card showed that the error rate of 19.3% represented an extra $3.6 million in erroneous claims, a 2% increase from the previous year. The AMA estimated that these faulty payouts and the hassles associated with them added $1.5 billion in administrative costs to the health care system.

"This report card conveys that the current state of the health care claims process is untenable," AMA board member Dr. Barbara L. McAneny said at the annual meeting of the AMA’s House of Delegates.

She said that 10%-14% of a physician’s revenue goes to dealing with administrative issues. The AMA is working with insurers and physicians to get that down to 1% of revenue.

The report card tracked a number of performance measures at Medicare and seven private insurers: Aetna, Anthem Blue Cross/Blue Shield, Cigna, Health Care Services Corp., Humana, Regence, and UnitedHealthcare.

UnitedHealthcare was the only insurer that improved its claims-processing accuracy from 2010, paying 90% of claims in an accurate manner. Anthem, on the other hand, paid only 61% of claims accurately.

The outright denial rate (in which no payment is made) ranged from a low of 17% of claims at Regence to 25% at Anthem and Cigna.

Prior authorization is a growing problem for physicians and constitutes one of the top eight reasons for denial of claims, according to Mark Rieger, CEO of National Healthcare Exchange Services, the company that conducted the analysis for the AMA. Coping with prior authorization is the second-largest administrative task for physicians, consuming at least 20 hours a week of physician and staff time, he said at the meeting.

Cigna had highest rate (6%) of claims requiring prior authorization; Regence had the lowest (0.04%).

There were some bright spots in the report. The vast majority of claims are now being paid within the first 15 days, with the remainder coming largely within 16-30 days of submission. Humana and Medicare were the fastest, paying some 95% of claims within 15 days. Cigna and Health Care Services Corp. were close behind.

The data were compiled by National Healthcare Exchange Services. The company analyzed claims submitted between Feb. 1 and March 31, 2011. Claims came from 42 states and included 4 million services billed on 2.4 million claims made by 400 practices covering 80 specialties.

CHICAGO – A sampling of claims payments from some of the nation’s top insurers shows that although they are paying much more quickly, some 23% of claims were denied and almost a fifth were paid incorrectly.

The study was conducted for the American Medical Association and issued June 20 at the organization’s annual House of Delegates meeting.

The 2011 National Health Insurer Report Card showed that the error rate of 19.3% represented an extra $3.6 million in erroneous claims, a 2% increase from the previous year. The AMA estimated that these faulty payouts and the hassles associated with them added $1.5 billion in administrative costs to the health care system.

"This report card conveys that the current state of the health care claims process is untenable," AMA board member Dr. Barbara L. McAneny said at the annual meeting of the AMA’s House of Delegates.

She said that 10%-14% of a physician’s revenue goes to dealing with administrative issues. The AMA is working with insurers and physicians to get that down to 1% of revenue.

The report card tracked a number of performance measures at Medicare and seven private insurers: Aetna, Anthem Blue Cross/Blue Shield, Cigna, Health Care Services Corp., Humana, Regence, and UnitedHealthcare.

UnitedHealthcare was the only insurer that improved its claims-processing accuracy from 2010, paying 90% of claims in an accurate manner. Anthem, on the other hand, paid only 61% of claims accurately.

The outright denial rate (in which no payment is made) ranged from a low of 17% of claims at Regence to 25% at Anthem and Cigna.

Prior authorization is a growing problem for physicians and constitutes one of the top eight reasons for denial of claims, according to Mark Rieger, CEO of National Healthcare Exchange Services, the company that conducted the analysis for the AMA. Coping with prior authorization is the second-largest administrative task for physicians, consuming at least 20 hours a week of physician and staff time, he said at the meeting.

Cigna had highest rate (6%) of claims requiring prior authorization; Regence had the lowest (0.04%).

There were some bright spots in the report. The vast majority of claims are now being paid within the first 15 days, with the remainder coming largely within 16-30 days of submission. Humana and Medicare were the fastest, paying some 95% of claims within 15 days. Cigna and Health Care Services Corp. were close behind.

The data were compiled by National Healthcare Exchange Services. The company analyzed claims submitted between Feb. 1 and March 31, 2011. Claims came from 42 states and included 4 million services billed on 2.4 million claims made by 400 practices covering 80 specialties.

CHICAGO – A sampling of claims payments from some of the nation’s top insurers shows that although they are paying much more quickly, some 23% of claims were denied and almost a fifth were paid incorrectly.

The study was conducted for the American Medical Association and issued June 20 at the organization’s annual House of Delegates meeting.

The 2011 National Health Insurer Report Card showed that the error rate of 19.3% represented an extra $3.6 million in erroneous claims, a 2% increase from the previous year. The AMA estimated that these faulty payouts and the hassles associated with them added $1.5 billion in administrative costs to the health care system.

"This report card conveys that the current state of the health care claims process is untenable," AMA board member Dr. Barbara L. McAneny said at the annual meeting of the AMA’s House of Delegates.

She said that 10%-14% of a physician’s revenue goes to dealing with administrative issues. The AMA is working with insurers and physicians to get that down to 1% of revenue.

The report card tracked a number of performance measures at Medicare and seven private insurers: Aetna, Anthem Blue Cross/Blue Shield, Cigna, Health Care Services Corp., Humana, Regence, and UnitedHealthcare.

UnitedHealthcare was the only insurer that improved its claims-processing accuracy from 2010, paying 90% of claims in an accurate manner. Anthem, on the other hand, paid only 61% of claims accurately.

The outright denial rate (in which no payment is made) ranged from a low of 17% of claims at Regence to 25% at Anthem and Cigna.

Prior authorization is a growing problem for physicians and constitutes one of the top eight reasons for denial of claims, according to Mark Rieger, CEO of National Healthcare Exchange Services, the company that conducted the analysis for the AMA. Coping with prior authorization is the second-largest administrative task for physicians, consuming at least 20 hours a week of physician and staff time, he said at the meeting.

Cigna had highest rate (6%) of claims requiring prior authorization; Regence had the lowest (0.04%).

There were some bright spots in the report. The vast majority of claims are now being paid within the first 15 days, with the remainder coming largely within 16-30 days of submission. Humana and Medicare were the fastest, paying some 95% of claims within 15 days. Cigna and Health Care Services Corp. were close behind.

The data were compiled by National Healthcare Exchange Services. The company analyzed claims submitted between Feb. 1 and March 31, 2011. Claims came from 42 states and included 4 million services billed on 2.4 million claims made by 400 practices covering 80 specialties.

CHICAGO – A sampling of claims payments from some of the nation’s top insurers shows that although they are paying much more quickly, some 23% of claims were denied and almost a fifth were paid incorrectly.

The study was conducted for the American Medical Association and issued June 20 at the organization’s annual House of Delegates meeting.

The 2011 National Health Insurer Report Card showed that the error rate of 19.3% represented an extra $3.6 million in erroneous claims, a 2% increase from the previous year. The AMA estimated that these faulty payouts and the hassles associated with them added $1.5 billion in administrative costs to the health care system.

"This report card conveys that the current state of the health care claims process is untenable," AMA board member Dr. Barbara L. McAneny said at the annual meeting of the AMA’s House of Delegates.

She said that 10%-14% of a physician’s revenue goes to dealing with administrative issues. The AMA is working with insurers and physicians to get that down to 1% of revenue.

The report card tracked a number of performance measures at Medicare and seven private insurers: Aetna, Anthem Blue Cross/Blue Shield, Cigna, Health Care Services Corp., Humana, Regence, and UnitedHealthcare.

UnitedHealthcare was the only insurer that improved its claims-processing accuracy from 2010, paying 90% of claims in an accurate manner. Anthem, on the other hand, paid only 61% of claims accurately.

The outright denial rate (in which no payment is made) ranged from a low of 17% of claims at Regence to 25% at Anthem and Cigna.

Prior authorization is a growing problem for physicians and constitutes one of the top eight reasons for denial of claims, according to Mark Rieger, CEO of National Healthcare Exchange Services, the company that conducted the analysis for the AMA. Coping with prior authorization is the second-largest administrative task for physicians, consuming at least 20 hours a week of physician and staff time, he said at the meeting.

Cigna had highest rate (6%) of claims requiring prior authorization; Regence had the lowest (0.04%).

There were some bright spots in the report. The vast majority of claims are now being paid within the first 15 days, with the remainder coming largely within 16-30 days of submission. Humana and Medicare were the fastest, paying some 95% of claims within 15 days. Cigna and Health Care Services Corp. were close behind.

The data were compiled by National Healthcare Exchange Services. The company analyzed claims submitted between Feb. 1 and March 31, 2011. Claims came from 42 states and included 4 million services billed on 2.4 million claims made by 400 practices covering 80 specialties.

CHICAGO – A sampling of claims payments from some of the nation’s top insurers shows that although they are paying much more quickly, some 23% of claims were denied and almost a fifth were paid incorrectly.

The study was conducted for the American Medical Association and issued June 20 at the organization’s annual House of Delegates meeting.

The 2011 National Health Insurer Report Card showed that the error rate of 19.3% represented an extra $3.6 million in erroneous claims, a 2% increase from the previous year. The AMA estimated that these faulty payouts and the hassles associated with them added $1.5 billion in administrative costs to the health care system.

"This report card conveys that the current state of the health care claims process is untenable," AMA board member Dr. Barbara L. McAneny said at the annual meeting of the AMA’s House of Delegates.

She said that 10%-14% of a physician’s revenue goes to dealing with administrative issues. The AMA is working with insurers and physicians to get that down to 1% of revenue.

The report card tracked a number of performance measures at Medicare and seven private insurers: Aetna, Anthem Blue Cross/Blue Shield, Cigna, Health Care Services Corp., Humana, Regence, and UnitedHealthcare.

UnitedHealthcare was the only insurer that improved its claims-processing accuracy from 2010, paying 90% of claims in an accurate manner. Anthem, on the other hand, paid only 61% of claims accurately.

The outright denial rate (in which no payment is made) ranged from a low of 17% of claims at Regence to 25% at Anthem and Cigna.

Prior authorization is a growing problem for physicians and constitutes one of the top eight reasons for denial of claims, according to Mark Rieger, CEO of National Healthcare Exchange Services, the company that conducted the analysis for the AMA. Coping with prior authorization is the second-largest administrative task for physicians, consuming at least 20 hours a week of physician and staff time, he said at the meeting.

Cigna had highest rate (6%) of claims requiring prior authorization; Regence had the lowest (0.04%).

There were some bright spots in the report. The vast majority of claims are now being paid within the first 15 days, with the remainder coming largely within 16-30 days of submission. Humana and Medicare were the fastest, paying some 95% of claims within 15 days. Cigna and Health Care Services Corp. were close behind.

The data were compiled by National Healthcare Exchange Services. The company analyzed claims submitted between Feb. 1 and March 31, 2011. Claims came from 42 states and included 4 million services billed on 2.4 million claims made by 400 practices covering 80 specialties.

CHICAGO – A sampling of claims payments from some of the nation’s top insurers shows that although they are paying much more quickly, some 23% of claims were denied and almost a fifth were paid incorrectly.

The study was conducted for the American Medical Association and issued June 20 at the organization’s annual House of Delegates meeting.

The 2011 National Health Insurer Report Card showed that the error rate of 19.3% represented an extra $3.6 million in erroneous claims, a 2% increase from the previous year. The AMA estimated that these faulty payouts and the hassles associated with them added $1.5 billion in administrative costs to the health care system.

"This report card conveys that the current state of the health care claims process is untenable," AMA board member Dr. Barbara L. McAneny said at the annual meeting of the AMA’s House of Delegates.

She said that 10%-14% of a physician’s revenue goes to dealing with administrative issues. The AMA is working with insurers and physicians to get that down to 1% of revenue.

The report card tracked a number of performance measures at Medicare and seven private insurers: Aetna, Anthem Blue Cross/Blue Shield, Cigna, Health Care Services Corp., Humana, Regence, and UnitedHealthcare.

UnitedHealthcare was the only insurer that improved its claims-processing accuracy from 2010, paying 90% of claims in an accurate manner. Anthem, on the other hand, paid only 61% of claims accurately.

The outright denial rate (in which no payment is made) ranged from a low of 17% of claims at Regence to 25% at Anthem and Cigna.

Prior authorization is a growing problem for physicians and constitutes one of the top eight reasons for denial of claims, according to Mark Rieger, CEO of National Healthcare Exchange Services, the company that conducted the analysis for the AMA. Coping with prior authorization is the second-largest administrative task for physicians, consuming at least 20 hours a week of physician and staff time, he said at the meeting.

Cigna had highest rate (6%) of claims requiring prior authorization; Regence had the lowest (0.04%).

There were some bright spots in the report. The vast majority of claims are now being paid within the first 15 days, with the remainder coming largely within 16-30 days of submission. Humana and Medicare were the fastest, paying some 95% of claims within 15 days. Cigna and Health Care Services Corp. were close behind.

The data were compiled by National Healthcare Exchange Services. The company analyzed claims submitted between Feb. 1 and March 31, 2011. Claims came from 42 states and included 4 million services billed on 2.4 million claims made by 400 practices covering 80 specialties.