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ISMA partner athenahealth gives you data on claims payment process
e-Reports, June 14, 2010
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PayerViewSM ranks payers in a dependable, quantitative report about which insurers have the most problems and successes
Each year, PayerViewSM provides you important feedback regarding the provider-payer relationship. The rankings, a project of athenahealth, Inc., and the practice management journal Physicians Practice, uses objective, data-driven methodologies to start an industry-wide dialogue on how breakdowns in the medical claims billing process can be addressed.

 Payer Rankings
 National  Midwest
#1 BCBS-RI

#2 Humana

#3 BCBS-MA

#4 UnitedHealthcare

#5 Tufts

#6 BCBS-OH

#7 Medicare B-GA

#8 Medicare B-NC

#9 Medicare B-OR

#10 ODS Health Plan

#1 Humana

#2 United Healthcare

#3 BCBS-OH

#4 Aetna & Aetna/US Healthcare

#5 Paramount Healthcare

#6 BCBS-IN

#7 BCBS-IL

#8 Medicare B-OH

#9 Medicare B-IN

#10 Medicare B-IL

This year’s results indicate health insurers are paying physicians on average seven days faster and denying 12-18 percent fewer claims than last year. A significant improvement in denial rate was seen across most payers.

For the second year in a row, Humana ranked first in overall performance in the Major Payer segment that also includes Aetna, Champus/TRICARE, Cigna, HCSC, Medicare B, UnitedHealth Group and Wellpoint. Humana also was first in the National Commercial Payer (also includes Aetna, Cigna and UnitedHealthcare), Midwest and West segments.

While Medicare B has improved its year-over-year performance, its rate of improvement lags behind national commercial payer peers.

Across all payer groups, however, Medicare continues to exhibit the most consistent performance, despite shouldering the burden for enforcing industry standards.

View further details and explore PayerView rankings here.

Want to discuss or learn more?
You can be part of an industry-wide dialogue on how breakdowns in the medical claims billing process can be addressed. On June 16 attend a FREE athenahealth webinar, “Payerview 2010: Improving the Way Providers and Payers Work Together.”

With the guidance of PayerView and the webinar, learn where payers and providers have their biggest problems – and successes. You’ll also see how your practice can benefit from improved billing processes, faster payment and fewer time-consuming billing problems.

Learn more about athenahealth and the upcoming webinar on the athenahealth ISMA web page.

Copyright: Information written and displayed on www.ismanet.org is the property of ISMA and may not be reproduced without expressed written permission of the Indiana State Medical Association.

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