The ACR is joining with the American Medical Association (AMA) in promoting November as “Heal that Claim” month.
“Heal that Claim” month is part of an ongoing campaign to repair the broken claims process, which is estimated to cost as much as $210 billion annually in unnecessary costs and causes physicians to divert substantial resources—as much as 14% of their total revenue—to ensure accurate insurance payments for their services.
“Heal that Claim” calls on all physicians and payers to do their part to eliminate waste in the claims process by getting it right the first time. Rheumatologists are encouraged to join other U.S. physicians in fighting for reimbursements that are rightfully theirs by:
- Reviewing their practices’ internal claims processes to ensure claims are submitted accurately and in a timely manner to the appropriate payer;
- Reviewing all claims payments for accuracy; and
- Appealing inappropriately underpaid or denied claims.
“Eliminating the inefficiencies of the billing and collections process can create significant savings that could reduce the rising cost of healthcare and be better used to enhance patient care,” explains AMA board member William A. Dolan, MD. Dr. Dolan sees the AMA’s goal as holding health insurance companies accountable for making the processing of claims more transparent and cost effective. To help in accomplishing this goal, Dr. Dolan would like to see physicians become more educated and empowered with the claims processing system so they are no longer at the mercy of a chaotic system that takes countless hours away from patient care.
In addition to helping physicians heal claims, the AMA has created a new National Health Insurers Report Card (NHIRC) that will provide physicians and the public with an objective and reliable source of information on the timeliness, transparency, and accuracy of claims processing by health insurance companies.
The NHIRC is based on a random sample from more than five million electronically billed services and provides an in-depth look at the claims processing performance of Medicare and seven national commercial health insurers: Aetna, Anthem Blue Cross Blue Shield, CIGNA, Coventry Health Care, Health Net, Humana, and United HealthCare. View a copy of the report card at www.ama-assn.org.
“Heal that Claim” month and its overall campaign will empower physicians to create a systematic approach to claims management and provide the necessary tools and education for rheumatology practices to start healing claims today.
For more information on “Heal that Claim” month, visit the AMA Web site at www.ama-assn.org. To learn more about the ACR’s involvement in “Heal that Claim” month or for tips on how your practice can get started, contact Antanya Chung, ACR director of practice management, at [email protected] or (404) 633-3777, ext. 818.
The ACR practice management department is your practice’s advocate and resource. Visit the Practice Management section of the ACR’s Web site, www.rheumatology.org/practice, for additional tips on billing and collections.
