The American Medical Association’s (AMA) fourth annual National Health Insurer Report Card has good news for some payers, but not for the industry as a whole.
Overall, the rate of inaccurate claims payments increased 2 percent since last year’s report card among leading commercial health insurers, the AMA said. The commercial claims processing error averages 19.3 percent, the latest study found. This results in $3.6 million in erroneous claims payments and $1.5 in unnecessary administrative costs in the health system, the AMA maintains.
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July 1st, 2011
The frustrating process of preauthorizing medical care with third-party payers does not have to take as much time as it does. Rhonda Buckholtz, CPC, CPMA, CPC-I, CGSC, COBGC, CPEDC, CENTC and vice president of business and member development for the AAPC discusses the need for staff to be better trained on how to work with health plans and simplify the process.
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April 14th, 2010
Getting paid for unlisted procedure codes can be tricky, especially if a procedure is experimental or investigational.
“It’s not unheard of to get paid for unlisted procedures, but it’s not always easy,” says Joanne Mehmert, CPC, CCS-P, in Kansas City, Mo. “The insurance company has its own definition of medical necessity.” (more…)
December 2nd, 2008