National Health Insurer Report Card

Hey All, Did you know that the American Medical Association (AMA) has created a National Health Insurer Report Card, with the first results release last year, 2008? For the start of this program the AMA assessed the following payers: • Medicare • United Healthcare • Aetna • Anthem BCBS • Cigna • Coventry • HealthNet • Humana The report card analyzes how each payer fares in 5 major categories: payment timeliness, accuracy, transparency of contracted fees and payment policy on payer websites, compliance with generally accept pricing rules, and denials. This is the most comprehensive assessment of health insurers I have ever seen. It will really begin the dialogue of forcing payers to be accountable for their actions, and to work with practices in ensuring proper payment. One interesting section in the report card deals with denials. It showed that you are more likely to get a denial from Medicare and Aetna, and least likely to get a denial from United Healthcare. You can download the report card from the AMA's website here: http://www.ama-assn.org/ama1/pub/upload/mm/368/reportcard-short.pdf (Special thanks to Dreama Sloan-Kelly, MD, CCS from MedicalCodingShop.com for the above information!)