AMA National Health Insurer Report Card Released


The AMA publishes an annual report card of the claims revenue cycle activities of the major commercial health insurers and Medicare. The NHIRC provides metrics on the timeliness, transparency and accuracy of claims processing of these payers in an effort to educate physicians and the public, and to reveal opportunities for improvement.

As part of the 2013 NHIRC, the first-ever Administrative Burden Index (ABI) was created to encourage increased physician and payer engagement. To access the newly released AMA Administrative Burden Index:

Here are the sections within the 2013 NHIRC; You can review the report results by section or as a whole.

• Payment timeliness
• Cash flow
• Accuracy
• Administrative requirements – prior authorization
• Claims edit sources & frequency
• Denials
• Improvement of claims cycle workflow

2013 NHIRC – full resultsPDF FIle

Download a comparison of the results from 2008-2013PDF FIle

These results may not be typical across all practices.  The practices profiled in the NHIRC have adopted best practices for electronic data interchange and contract compliance.  Also, the company that compiles the results uses information from the standard transactions in ways that are not described in the implementation guide in order to help improve match rate.  To enable all physician practices to achieve results similar to those reported here, all health insurers must be fully transparent and compliant with the electronic data interchange standards.

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