AMA: Health insurance companies botch up to 20 percent of claims

Thursday, June 23, 2011 by: Jonathan Benson, staff writer
Tags: health insurance, claims, health news

(NaturalNews) Many NaturalNews readers have likely experienced, if even just once, the hassle of having their health insurance company improperly file a insurance claim, which can result in filing disputes, delayed payments, and other administrative problems. According to the American Medical Association (AMA), as many as 20 percent of health insurance claims are improperly filed, which reportedly adds an additional $17 billion a year to the overall healthcare burden.

The new AMA report explains that insurance company filing errors have increased two percent over last year's figures, now topping 19.3 percent. Among the top insurers, UnitedHealth had the lowest error rate of 9.77 percent. Regence Group Blue Cross Blue Shield was next at 11.59 percent, followed by Health Care Service Corp. at 12.96 percent. Anthem Blue Cross Blue Shield had the worst error rate at 38.95 percent.

"A 20 percent error rate among health insurers represents an intolerable level of inefficiency that wastes $17 billion annually," said Dr. Barbara McAneny, an AMA board member and medical oncologist from New Mexico, to the Chicago Tribune. "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."

On the positive side, the report explains that insurance companies are doing a better job of reducing "denial rates" these days, and it also notes an improvement in insurance company response time to claims. But many doctors still do not submit claims electronically, which the AMA claims may be responsible for delaying some claims.

Meanwhile, the AMA's expressed support for the provisions in last year's health care overhaul is likely responsible for the group's loss of 12,000 members last year (http://www.chicagotribune.com/business/feed/...). Many former AMA members oppose the group's endorsement of the health care bill's individual mandate, which requires individuals to purchase health coverage.

Sources for this story include:

http://www.chicagotribune.com/business/break...