As in previous years, the AMA completed their National Health Insurer Report Card, outlining the countless issue with carrier’s correctly processing and paying claims. According to the 2012 study, it was found that commercial payors allowed amounts match individual practices expected payment levels 90% of the time. This means that 1 out of 10 line items are effectively underpaid. APS’ proprietary contract management system continues to monitor payment levels by line item to identify these mistakes. Underpayments are flagged in real time and a specialist is notified to contact the at fault carrier and collect all money owed to each client.
In working through the wide variety of billing arrangements, APS found payments that we had been missing.