Skip to main content

Healthcare providers rely on data for claim accuracy

Rachel Wheeler Archive
Yvonne Daily recently faced a problem that one in 10 Americans will face when they open their bills from health insurance providers - inaccurate information. A recent article from Reuters explains Daily's story and highlights data revealed by an American Medical News study on the accuracy of health insurers across the United States.

While insurers have managed to reduce the number of mistakes in claims over the past year, from 19.3 percent in 2011 to 9.5 percent in 2012, the 10 percent margin of error affects a significant number of patients every year. For Daily, that meant a denied claim for her $1,500 nebulizer treatment, Reuters explains. At the root of the problem was a missed code for her diagnosis, which was cited as anxiety instead of asthma.

Billing mistakes aren't only bad for patients, they can affect the practice's bottom line. To ensure claims are correctly processed, healthcare providers should employ a system that verifies data quality.

The American Medical Association recently announced another measure aimed to streamline reporting and improve data accuracy across the healthcare industry. The association released guidelines for insurers who provide information to physicians as a way to ensure this data can be read and used for accurate decision making upon arrival.

"The organizations who have pledged to use the AMA guidelines recognize that providing physicians with ineffective or inaccurate practice data represents a missed opportunity," said AMA president Jeremy A. Lazarus.