|Aetna Pays Medical Providers The Fastest Among National Commercial Insurers
Aetna pays medical providers the fastest among national
commercial insurers according to athenahealth Inc., a provider of
Internet-based business services to physician practices.
athenahealth Inc. released its third annual PayerView
Rankings that placed Aetna as the new numberone overall ranking among
national payers for their business dealings with physicians.
This year’s rankings are based on athenahealth
claims performance data from more than 12,000 medical providers
representing over 30 million medical charge lines for all four quarters
of 2007, the company said.
The PayerView Rankings are designed to look at
payers’ performance based on a number of categories, which
combine to provide an overall ranking aimed at quantifying the "ease of
doing business with the payer," athenahealth said.
According to the company, key findings and trends from the 2008 PayerView Rankings are:
- Aetna’s greatest performance gain was realized
from a 10.6 percent reduction in its denial rate, which also provided
Aetna with the best denial rate across the national payers. Across the
other metrics, Aetna either maintained or improved its rank including
the fastest payment to providers for the second straight year, which
gave it the edge to surpass last year’s leader, CIGNA Healthcare.
- Medicaid-New York ranked last for the third straight
year in the days in account receivable metric among all payers ranked.
That program took on average over 137 days to pay a medical claim
submitted by an athenahealth client, compared to an average of 33 days
for national commercial carriers.
- Patient liability for the national payers was only up
slightly at 0.4 percent compared to a 19 percent increase experienced
last year. Both Humana and UnitedHealthcare launched new real-time
adjudication projects with athenahealth in 2007 to address the growing
demand on providers to collect payment from patients with new
consumer-centric benefit plans.
- The Centers for Medicare and Medicaid Services
National Provider Identifier (NPI) initiative caused a great deal of
confusion for providers in 2007 concerning which payers would adhere to
the original, May 23, 2007 deadline, and what each payer’s
contingency plans were. Payers had varying instructions for providers
for how to exchange NPI information, which was needed for a payer to be
able to process a medical claim – this resulted generally in
increased denials rates and multiple submissions to resolve. While this
impact was still small in 2007, the industry may feel the full impact
in 2008 when the requirement officially goes into effect.
Address: athenahealth Inc., 311 Arsenal St., Watertown, MA 02472; (800) 981-5084, www.athenahealth.com.