AMA: 20% of Medical Claims Processed Incorrectly by Health Insurers

Despite all the scrutiny upon providers in terms of submitting accurate claims, a recent study by the American Medical Association (AMA) shows health insurance companies should also be held responsible for improper processing of claims. In the study, the AMA found that one in five medical claims is processed incorrectly by health insurers. Health insurers had an accuracy rate for processing and paying claims of 80% overall.

About $777.6 million in administrative costs could be saved if the health insurers improved their claims payment accuracy by a mere 1 percentage point. Getting to 100% claims payment accuracy could save up $15.5 billion annually. The AMA believes that these deficiencies could be corrected by creating a single transparent systemwide set of processing and payment rules which would create systemwide savings while allowing physicians to direct time to patient care instead of excess paperwork.

For more information on this topic, feel free to call Robert S. Iwrey, Esq., Adrienne Dresevic, Esq., Jessica L. Gustafson, Esq., Carey F. Kalmowitz, Esq., or Abby Pendleton, Esq. of The Health Law Partners at (248) 996-8510.