Administrative Burden Index - Score 1
Administrative burden associated with delayed remittance response
Data for these scores are taken from the NHIRC "Metric 2A": Cash flow anaylsis. The percent of claims paid after 30 days was used to calculate the ABI score.
The AMA's goal is 0% of claims paid after 30 days to reduce the most administrative burden and to move the health care system to real-time adjudication or estimation at the time of service. This eliminates the need for patient invoicing and related follow-up communications, as it allows practices to reconcile patient accounts prior to the patient leaving the office.
 All scores in the Administrative Burden Index refer to metrics outlined in the National Health Insurer Report Card. Visit www.ama-assn.org/go/reportcard for a full metric description and methodology.
- Automate claims revenue cycle workflows through the use of electronic transactions, with help from the AMA's toolkits at www.ama-assn.org/go/electronictransactions, or through use of the AMA's Claims Workflow Assistant at www.ama-assn.org/go/claims-assistant.
- Take advantage of automated solutions offered by payers, which are highlighted at
www.ama-assn.org/go/payerpolicies on the AMA's payer policies website.
- Move toward point-of-care pricing with help from the AMA's toolkit available at www.ama-assn.org/go/poc.
The ABI score was created to assist physicians in identifying the cost of doing business with the participating payers in the NHIRC. For simplicity, a grading scale, similar to educational system grading scales which use 0-100 point scales, was utilized. An exception was made so that a score of 100 points was required to receive five stars, instead of the traditional 90-100 points for the top grade.
Therefore, an ABI score of:
- 100 is equal to five stars
- 90-99 is equal to four stars (95-99 is awarded an additional ½ star)*
- 80-89 is equal to three stars
- 70-79 is equal to two stars
- 60-69 is equal to one star
- 59 or lower is equal to zero stars
*Payer scores of 95-99 that fell in the 4 star category were given additional recognition of a ½ star to acknowledge their efforts to reach the AMA goals.