As part of its national campaign to save billions of dollars by improving the accuracy and efficiency of medical claims processing, the American Medical Association has selected November for the first national Heal that Claim Month.
An estimated 90 percent of claim denials are preventable and 67 percent of denials are recoverable, according to the Advisory Board Company, a Washington-based research organization. Based on those estimates, physicians collectively lose billions of dollars a year in revenues to health insurers.
"The AMA is encouraging both physicians and insurers to take steps to prevent claim denials and improve the efficiency of billing and collections during Heal that Claim Month," said William Dolan, MD, an AMA board member. "Insurers should pay claims accurately the first time, and comply fully with federal standards for electronic transactions to make claims processing as easy and transparent as possible."
To help physicians participate in Heal that Claim Month, the AMA is offering tools to physicians for cutting through the ambiguity and bureaucracy of processing claims with health insurers. The online resources can help physicians and their staff create a systematic approach to claims management and offer instructions on preparing, tracking and appealing claims when necessary. The tools are available to all physicians at no charge through the AMA's Practice Management Center.
"The AMA's Practice Management Center can help physicians focus on caring for their patients instead of battling health insurers over delayed, denied or shortchanged payments for their services," said Dolan. "Studies suggest that physicians divert 14 percent of their revenue to a costly fight for fair reimbursement."
The Practice Management Center's library of education materials includes interactive, user-friendly tools and resources such as template appeal letters and printable checklists and logs that help physicians simplify their claims management revenue cycle.