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Medicare outperforms commercial insurers in accuracy of reimbursement


Insurance companies often fail to properly reimburse doctors, needlessly adding more than $200 billion a year to the nation's healthcare tab, the American Medical Assn. said Monday.

An analysis of 3 million medical claims over a six-month period beginning in October also found that doctors in the U.S. spend 14% of the fees they receive from insurers and Medicare on the process of collecting those fees, the AMA said in a report issued at its annual meeting in Chicago.

The analysis sized up insurers and Medicare on how often they paid on time, how often they denied claims and how often they paid at the contracted rate and other measures.

Medicare outperformed commercial insurers in many areas, and some insurers paid physicians' bills better than others.

For example UnitedHealthcare, whose parent owns California's PacifiCare, paid physicians the contracted fee 62% of the time. By comparison, Aetna Inc. paid the contracted fee 71% of the time and Medicare paid the set fee 98% of the time.

at http://www.latimes.com/business/la-fi-insure17-2008jun17,0,4571342.story .

The article is a quantitative argument for how single payer could save all of us money through reduction of administrative expenses.

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