Many Variations in Claims Processing
Another May 2006 survey has ranked insurance carriers by their payment speeds, denial rates, adherence to national standards, and more. Called PayerView (available online at www.athenapayerview.com ), this survey by athenahealth, a provider of physician services including outsourced billing, analyzed claim performance data from more than 7,000 providers during the last quarter in 2005. Among its findings:
Some insurance companies don’t pay well and we know that. It’s not rocket science; it’s just practical experience. – -Lee Eisenberg, MD
- National carrier Aetna denies claims twice as often as the top performer, Humana.
- Cigna led all carriers in the category that measures the percentage of claims found to be not on file at the payer after inquiry by the physician.
- Wellpoint was the most aggressive shifter of responsibility to physicians to secure payment from patients directly.
- The average number of days a claim is in accounts receivable among national payers is 38.
In a press release announcing the survey, athenahealth co-founder and CEO Jonathan Bush claims that by making these rankings publicly available, we hope to illustrate the significance and scope of this national problem, help insurers recognize the source of process breakdown, and work to improve their reimbursement practices for everyone involved.