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National Health Insurer Report Card

The AMA publishes an annual report card of the claims revenue cycle activities of the major commercial health insurers and Medicare. The NHIRC provides metrics on the timeliness, transparency and accuracy of claims processing of these payers in an effort to educate physicians and the public, and to reveal opportunities for improvement.

Access the newly released AMA Administrative Burden Index
As part of the 2013 NHIRC, the first-ever Administrative Burden Index (ABI) was created to encourage increased physician and payer engagement.

2013 NHIRC
Review the report results by section or as a whole.

These results may not be typical across all practices.  The practices profiled in the NHIRC have adopted best practices for electronic data interchange and contract compliance.  Also, the company that compiles the results uses information from the standard transactions in ways that are not described in the implementation guide in order to help improve match rate.  To enable all physician practices to achieve results similar to those reported here, all health insurers must be fully transparent and compliant with the electronic data interchange standards.

 
2013 NHIRC press release

This press release provides a high-level summary of 2013 NHIRC findings, and provides an explanation of how those numbers translate to spending across the health care industry.

View the press release

2013 NHIRC and ABI webinar

View a webinar about the AMA's 2013 National Health Insurer Report Card (NHIRC) results and introduction of the Administrative Burden Index (ABI). Learn about payer improvements from the previous NHIRC results. To further apply the AMA’s NHIRC results, the first-ever ABI was created to encourage increased physician and payer engagement. Using this index, physicians can identify ways to reduce current administrative burdens being experienced in the physician practice claims revenue cycle. Watch this webinar to understand how this index can help your practice determine automation priorities, and how the index can also be used in conjunction with contracting.

View the webinar

2013 Statement of methodology

Understand the method by which the National Health Insurer Report Card is developed. This document is an informative brief on the AMA’s process for developing a report that is comprehensive, accurate and defensible.

View the Statement of Methodology

Take a stand against administrative waste

The National Health Insurer Report Card is the cornerstone of the AMA’s “Heal the Claims Process”™ campaign, which aims to streamline claims processing through the use of electronic health care transactions and reduce the administrative cost of claims processing from 14 percent of gross revenue to just 1 percent.

Learn how the National Health Insurer Report Card and the “Heal the Claims Process”™ campaign have transformed health care and how the AMA is continuing the fight for administrative simplification.

Resources to help your practice become an ePractice

Streamline your claims process. Access resources to help your practice become electronic or an ePractice, by using electronic eligibility verification, electronic claim submission, claim status, prior authorization/referrals, electronic remittance advice and electronic funds transfer.

Access the toolkits and archived webinars on electronic transactions

Past report cards

The AMA keeps an archive of past National Health Insurer Report Cards. These past reports may be a useful resource for understanding health insurer performance over time.

View past report cards

LinkedIn Discussion Group
Join discussions in the AMA Administrative Simplification LinkedIn Group.