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AMA releases its 2nd National Health Insurer Report Card

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The American Medical Association has released its second National Health Insurer Report Card, that finds health plans are earning better grades for administrative simplification but still have a long way to go.

Health Data Management outline the key findings of the report card, which include:

  • Insurers continue to vary widely in how often they deny claims. The inconsistent reasons used to explain the denials indicate a “serious lack of standardization.”
  • Private health insurers correctly reported the expected contracted rate to physicians 72% to 93% of the time in 2009, compared with 62% to 87% in 2008.
  • Prompt-pay laws are leading more insurers to more quickly respond to electronic physician claims.
  • Most insurers now provide physicians with at least some Web access to their payment policies, although information on prior authorization of services is lacking.

The report card findings are based on a random sampling of about 1.6 million electronic claims for about 2.5 million medical services submitted in February and March to eight payers, including Medicare.

To view the findings, visit

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