 Paying
Health Care Providers
Quickly and Accurately
Dear Physician and Office Staff:
At Humana, we understand the importance
of making sure providers are paid quickly and accurately the first
time around. Despite the fact that 50 percent of all health insurance
claims are still being filed on paper, there is an industry-wide
movement to shorten the payment cycle, and the growing trend toward
submitting claims electronically is the impetus. This trend isn’t
unique to Humana, but what sets us apart is our strong focus and
commitment to making this happen.
Since expediting our payment process two years ago, Humana has achieved
measurable results. Over 96 percent of electronic claims sent to
Humana are adjudicated within seven days of receiving them. (For
paper claims, this rate is slightly less than 80 percent.) Humana’s
first-pass auto adjudication rate – across all Humana claims
payment systems – is now 72 percent.
Filing claims electronically has been shown to reduce the average
error rate to less than 2 percent, according to Claims Transit,
a medical claims management company. Most important, claims automation
helps put funds back into the pockets of providers and reduces administrative
expenses.
Recently, Humana increased the frequency with which claim checks
are issued, from once to twice a week, reducing the time frame in
which Humana network providers receive payments by as many as six
days. We now distribute checks every Sunday and Wednesday. This
means that claims that come in on Monday or Tuesday are usually
finalized on Wednesday; the checks are typically issued on Wednesday
and go out on Thursday. Since we increased our payment speed, duplicate
claim submissions have been cut in half, and physicians’ offices
have collected patient payments more quickly.
As you read this issue of Humana’s YourPractice,
you will find more information about electronic claims filings,
including details on how we are expanding a system that automatically
submits electronic Medicare claims data to Humana. We hope all of
the information on electronic claims and automation that you read
here will reinforce for you our efforts to continue to pay physicians
and other care providers more quickly and accurately.
Sincerely,
Bruce Perkins
Senior Vice President, Humana, and
President, ChoiceCare Network
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