“Heal the Claims Process” Campaign

How many times have you wished that health insurance companies would make claims processing more cost effective? To help deal with this problem, the AMA launched the “Heal the Claims Process” campaign during the Annual Meeting of the AMA House of Delegates. The focus of this campaign is “to dramatically reduce the unnecessary administrative burden of ensuring accurate insurance payments for physician services.” The campaign aims to:

1. Encourage physicians and staff to submit claims accurately and in a timely fashion

2. Empower physicians to demand fair payment from health insurers

3. Call on all payers to fully comply with the HIPAA electronic claims transactions standards

4. Have all payers give payment accurately and in a timely manner the first time after receiving a claim

The AMA has developed a number of useful tools for the campaign, including the National Health Insurer Report Card, which is designed “to act as a source of accountability for critical measures concerning the timeliness, transparency and accuracy of health insurers’ claims processing;” the results of the first report card can be accessed on the AMA website.

The AMA has declared November to be “Heal that Claim” month, an “ideal time to appeal inappropriately underpaid or denied claims;” instead of “accepting increased claims underpayments and denials, physician practices can appeal these claims and collect their appropriate payment in January and February.”

Click here to access the “Heal the Claims Process” toolkit, a resource to help physicians get accurate payment on claims, and practice management tips on reducing administrative costs.