AHIP Responds to AMA’s Health Insurer Report Card |
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Written by U. S. Insurance News
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Monday, 23 June 2008 |
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Now that the American Medical Association (AMA) has released its report
card on the state of processing physician claims, the Washington,
D.C.-based America’s Health Insurance Plans (AHIP) wants to state its
case as well.
As part of a statement she released following the AMA report, Karen Ignagni, AHIP president and CEO, stressed that administrative simplification that benefits consumers and physicians is a “top priority” for the AHIP.
Ignagni cited recent data from PricewaterhouseCoopers that show administrative costs have been stable for four decades.
“As a result of the move to electronic processing, the cost for each claim has actually declined, enabling insurers to provide value-added services to consumers, such as disease management programs, without contributing to rising health care costs,” Ignagni said.
Furthermore, Ignagni pointed out that AHIP research shows that virtually all “clean” claims are processed within 30 days.
“AHIP members have worked collaboratively with physicians to make improvements in processes to promote efficiency and move to real-time payment,” she said. “In order for claims to be processed as efficiently and promptly as possible, both insurers and physicians need to strive for accuracy and timeliness.”
Flaws in the claims process are not entirely the fault of insurers, Ignagni pointed out.
“Data show there is often a significant lag time between when services are provided and physician claims are submitted. Data also indicate that there are a significant number of incomplete and duplicate claims filed,” she said.
Ignagni concluded, “Our view is that discussions of efficiency are important, but that they should be broad discussions of opportunities for improvement by all the responsible stakeholders.”
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