The number of claims filed electronically has increased substantially from four years ago, decreasing processing costs and speeding up payment, according to a survey of 25 million claims by America’s Health Insurance Plans. Seventy-five percent of claims are now submitted electronically, compared with 44% in 2002, and cost almost half as much to process--$0.85 for a clean electronic claim versus $1.58 for a clean paper claim. Yet although 69% of electronic claims are processed within seven days versus 29% of paper claims, the percentage of providers who wait to submit claims until 30 days after service--29%--is virtually unchanged from four years ago. For the 14% of all claims that are delayed, 35% are slowed because duplicate claims were submitted, 12% lack complete information, and 1% contain invalid codes. Read the survey.
In related news, athenahealth, Inc., a billing and practice management software company for physicians, has ranked national and regional health insurers on their ability to efficiently pay claims. The rankings consider such measures as the length of time an insurer takes to pay a claim, the percentage of claims that get paid in full the first time they are submitted, and denial rate. Among the results: Aetna denied claims twice as often as Humana, Cigna led all carriers in requiring providers to resubmit claims because the insurer says they are not on file, and Wellpoint was the most aggressive in requesting physicians to secure payments from patients directly.
