AMA issues first report card on health insurers
By CARLA K. JOHNSON, Associated Press Writer Mon Jun 16, 6:18 PM ET
Some health insurance companies rate doctors on their performance. Now doctors are turning the tables.
The American Medical Association issued its first health insurance report card at the group's annual meeting Monday. The primary focus is on how quickly and accurately doctors get paid.
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UnitedHealthcare had the lowest rate of contract compliance, according to the AMA report. About 62 percent of medical services billed were paid by UnitedHealthcare at the contracted rate, compared with 71 percent for Aetna and 98 percent for Medicare.
UnitedHealthcare spokesman Gregory Thompson said doctors and their billing services share responsibility for prompt payment. "Data show there is often a significant lag time between when services are provided and physician claims are submitted," he said.
He said UnitedHealthcare has improved its electronic claims systems and noted the AMA gave the company higher ratings on other measures.
Medicare performed better than the private insurers in most areas, said Dr. Lawrence Casalino, a University of Chicago health economist and former physician. Commercial insurance plans compete by promising employers that they are tough on holding down the cost of claims, he said.
"There's no question that administrative costs for doctors and the country would be a lot lower in a single-payer system," Casalino said in an interview after the meeting. But a market-based system has advantages of competition, choice and innovation, he said. "Are the benefits enough to justify the cost?"
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