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Administrative Burden Index - Score 2

Administrative burden associated with inaccuracy of payment expectations

Data for these scores are taken from the NHIRC "Metric 6": First ERA accuracy[1]

The AMA's goal is to move the health care system to achieve 100 percent accuracy in the payment of claims in order to decrease time and costs related to claims re-processing.

ABI 2

 

[1] 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 full metric descriptions and methodology.

What can physicians do after reviewing ABI scores?

Scoring and five-star ratings

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.