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AMA finds increasing inaccuracy in health insurance claims payments
By Insure.com staff

Commercial health insurance companies have a 19.3 percent error rate in processing claims, a 2 percent increase over last year's error rate, according to the American Medical Association's (AMA) fourth annual National Health Insurer Report Card.

The error rate increase added an estimated $1.5 billion in unnecessary administrative costs to the health care system, according to the AMA. Eliminating claims payment mistakes would save $17 billion annually.

"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," AMA Board Member Dr. Barbara L. McAneny said in a media statement.

The report card is based on a random sampling of about 2.4 million electronic health insurance claims for approximately 4 million medical services submitted in February and March to Aetna, Anthem Blue Cross Blue Shield, CIGNA, Health Care Service Corp., Humana, The Regence Group, UnitedHealthcare and Medicare. The report is a cornerstone of the association's 3-year-old campaign to spur improvements in the industry's billing process.

UnitedHealthcare was the only commercial health insurer included in this year's report card to improve accuracy. The company came out on top with a 90 percent accuracy rating. Anthem Blue Cross Blue Shield scored the worst, with an accuracy rating of 61 percent.



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