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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