| While it is usual for health insurance companies | | | | insurance, but she has more time with patients. |
| rate doctors on their performance, it is now | | | | UnitedHealthcare had the lowest rate of contract |
| becoming the other way round. American Medical | | | | compliance, according to the AMA report. About |
| Association issued its first health insurance report | | | | 62 percent of medical services billed were paid by |
| card at the group's annual meeting Monday. The | | | | UnitedHealthcare at the contracted rate, |
| primary focus is on how quickly and accurately | | | | compared with 71 percent for Aetna and 98 |
| doctors get paid. "Physicians are spending 14 | | | | percent for Medicare. |
| percent of their total revenue to simply obtain | | | | UnitedHealthcare spokesman Gregory Thompson |
| what they've earned," said Dr. William Dolan, an | | | | said doctors and their billing services share |
| AMA board member. | | | | responsibility for prompt payment. "Data show |
| Dr. Dolan explained that the report card is an | | | | there is often a significant lag time between when |
| effort to reduce the cost of claims processing to | | | | services are provided and physician claims are |
| doctors and help them as they negotiate | | | | submitted," he said. |
| contracts with insurance companies; adding that | | | | He said UnitedHealthcare has improved its |
| the report card will help patients if it reduces | | | | electronic claims systems and noted the AMA |
| wasteful administrative costs. The report card | | | | gave the company higher ratings on other |
| compares Medicare and seven national commercial | | | | measures. |
| health insurers on the timeliness and accuracy of | | | | Medicare performed better than the private |
| claims processing. It is based on a random sample | | | | insurers in most areas, said Dr. Lawrence Casalino, |
| drawn from 3 million claims. | | | | a University of Chicago health economist and |
| There are no grades like A, B and C, and many | | | | former physician. Commercial insurance plans |
| of the technical measures may not mean much | | | | compete by promising employers that they are |
| to most patients. But business leaders and health | | | | tough on holding down the cost of claims, he said. |
| policy makers are interested in cutting an | | | | "There's no question that administrative costs for |
| estimated annual $210 billion in wasted | | | | doctors and the country would be a lot lower in a |
| administrative claims processing costs, AMA | | | | single-payer system," Casalino said in an interview |
| leaders said. | | | | after the meeting. But a market-based system |
| Four years ago, Dr. Marcy Zwelling got so | | | | has advantages of competition, choice and |
| frustrated with the time and cost of making sure | | | | innovation, he said. "Are the benefits enough to |
| she was paid accurately by insurers that she | | | | justify the cost?" |
| stopped dealing with them. She now runs a | | | | Peter Lee of the Pacific Business Group on Health |
| so-called "boutique" practice. Most of her patients | | | | welcomed the report card, but said he hoped the |
| pay her an annual fee out of their own pockets. | | | | AMA would look at a broader range of areas that |
| "The best thing is, I get to be a doctor" instead | | | | would be helpful to consumers. |
| of a claims processor, said Zwelling, of Los | | | | "Increased payments to physicians means |
| Alamitos, Calif. She says she doesn't make any | | | | increased premiums and increased costs in a |
| more money than she did when she accepted | | | | system that is spiraling out of control," Lee said. |