May 26, 2010 | iHealthBeat
Last year, most private health insurance companies made strides in using technology to improve their provider medical claims processing rates, resulting in marked improvements in transaction speeds of the reimbursements, according to the fifth annual PayerView rankings report released today, the Boston Globe reports.
The rankings report was compiled by Athenahealth, a vendor of billings and records applications, in collaboration with the Physicians Practice management journal. For the report, researchers drew from a database of 24,000 health care providers in 45 states to assess 137 insurers.
According to the PayerView report, health care providers in 2009 on average received their payments seven days faster than they did in 2008. In addition, insurers denied 12% to 18% fewer claims, the report found.
Inefficiencies Remain
Despite the noted progress, the researchers found that inefficiencies remain in the claims reimbursement system. Furthermore, the report notes that state-administrated Medicaid programs nationwide continue to lag behind in their use of technology to accelerate claims processing.
The majority of secondary operations at hospitals, physicians' offices and insurers still are slow and disorganized because the fragmentation of the health care industry makes it difficult to develop technology and transaction standards, according to the researchers.
Jeremy Delinsky, senior vice president at Athenahealth, said, "It's mind-boggling how much waste there is," adding, "Health care transactions in the United States are not done in real time the way transactions are done in almost every other industry." Delinsky noted, "Even in the fastest cases, it can still take three weeks for doctors to get paid" (Weisman, Boston Globe, 5/26).
