AMA campaign tackles insurance claims process

In an attempt to remedy the pressures associated with insurance claims reimbursement for physician services, the American Medical Association has launched the Cure for Claims campaign simultaneously with its first National Health Insurer Report Card on claims processing.

“The goal of the AMA campaign is to hold health insurance companies accountable for making claims processing more cost-effective and transparent and to educate and empower physicians so they are no longer at the mercy of a chaotic payment system that takes countless hours away from patient care,” said AMA board member William A. Dolan, MD. “Eliminating the inefficiencies of the billing and collection process would produce significant savings that could be better used to enhance patient care and help reduce overall health care costs.”

The AMA Cure for Claims campaign will empower physicians to create a systematic approach to claims management. To help physicians submit accurate claims, the AMA has created the Practice Management Center, an online resource with tools for preparing claims, following their progress, and appealing when necessary.

The AMA’s new National Health Insurer Report Card, based on a random sample of more than 5 million electronically billed services, offers a close view of the claims processing performance of Medicare and seven national commercial health insurers: Aetna, Anthem Blue Cross Blue Shield, CIGNA, Coventry Health Care, Health Net, Humana, and United Healthcare. Areas of focus include denials, contracted payment rate adherence, and transparency of fees and payment policies.