"Heal That Claim:" Take action against inaccurate insurance payments

The American Medical Association (AMA) today urged physicians to take action this fall against inaccurate payments from private health insurers. The AMA has designated November as Heal that Claim™ month and is supplying physicians with tools to fight flawed and inefficient claims processing by health insurers.

One in five medical claims is processed inaccurately by commercial health insurers, according to the AMA’s National Health Insurer Report Card. A 20 percent error rate represents an intolerable level of inefficiency that wastes an estimated $15.5 billion annually. The administrative costs of ensuring proper insurance payments takes a heavy financial toll on physicians, and can consume up to 14 percent of their earned revenue.

“The AMA’s goal is to significantly reduce the administrative costs of processing claims from 14 percent to one percent and allow doctors to focus on caring for patients, instead of battling health insurers over delayed, denied or shortchanged medical claims,” said AMA President Cecil B. Wilson, M.D..

November is an ideal time for physicians to bolster their efforts at appealing inappropriately denied claims since health insurers often increase claim denials during the last quarter of the year. The AMA is helping physicians overcome claims obstacles by offering easy-to-use online resources to help prepare, track and appeal claims. These resources include template appeal letters, printable checklists and logs that help physicians simplify their claims management system.

To learn more about how the AMA is helping physicians get paid accurately by health insurers, visit the AMA’s Heal the Claims Process™ campaign. Physicians can pledge support for the campaign, report any unfair health insurer practices, share successes or sign up for the AMA’s free e-mail alerts to help stay up to date on unfair payer practices.