20% of all medical claims processed incorrectly

By Bruce Japsen
Tribune staff reporter
9:00 a.m. CDT, June 20, 2011

Health insurance companies are inaccurately processing nearly one in five medical claims, slowing payments to doctors and adding bureaucratic headaches to patients, the American Medical Association said this morning.

In its annual report card on the health insurance industry, released during the the group's annual House of Delegates meeting here, the AMA said commercial health insurance companies have an error rate of 19.3 percent, a two percentage increase from last year's report.

Improving claims processing could save patients money and improve medical care by reducing hassles physicians have when they are forced to haggle with health plans over payments or other issues. The AMA said the report is designed to hold insurance companies accountable.

"A 20 percent error rate among health insurers represents an intolerable level of inefficiency that wastes $17 billion annually," said Dr. Barbara McAneny, an AMA board member and medical oncologist from New Mexico. "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."

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If this were about Medicare the repubs and MSM would be screaming from the rooftops. Bet they won't say a word about it.

or just goes away, and I've had some GIGANTic bills over the last few years

I find whenever I submit a large claim it gets turned down, almost automatically. Sometimes I have to appeal twice before finally getting paid.

I find whenever I submit a large claim it gets turned down, almost automatically. Sometimes I have to appeal twice before finally getting paid.

Someone incorrectly identified me as "F" on the lab request and the insurance company refused to pay because it knew I was an "M"

This went back and forth and the bill with to collection. I finally got both my doctor's office and the lab on the phone and worked it out. I was told every thing would be taken care of.

Now, a recent look at my credit report shows I had a bill go to collection.

So much for the "best health care in the world."

by the information coming from the federal pre-existing condition pool about what they've been paying for. The puzzle being I can't tell half the time. I'm also puzzled I never got an itemized hospital bill so I might verify the charges as much as I could. Heaven knows I'm grateful for all that's been covered, but if this is the way things are done now, I imagine providers who aren't on the up and up could really pad a bill which would, of course, drive up insurance prices.