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What Anesthesiologists Should Know About Third Party Payer Performance

The American Medical Association (AMA) and the Medical Group Management Association (MGMA) offer tools that allow physicians, policy makers and others to evaluate the performance of a number of third party payers including Medicare. The AMA and MGMA information may help anesthesia and pain medicine groups who contract with private payers to identify potential problem areas and to prepare to negotiate for specific performance standards and remedies for non-compliance. The AMA’s National Health Insurer Report Card contains metrics on the timeliness, transparency and accuracy of claims processing by the payers analyzed.  The information in the latest annual report is derived from a random sampling of 2.6 million electronic claims submitted by more than 450 physician practices across 41 states in February and March of this year to Aetna, Anthem Blue Cross Blue Shield, Cigna, Health Care Service Corporation, Humana, Regence, United Healthcare and Medicare.  Below are some of the key findings...
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