Web site tells how fast insurers pay

A claims-processing company combs its records to find out which plans give physicians the most -- and least -- hassle.

By Jonathan G. Bethely, AMNews staff. June 19, 2006.

Even though just about every state has prompt-pay laws, Frederic Ettner, MD, of Evanston, Ill., is one of many physicians who would argue that insurer payments aren't terribly prompt. In his current worst-case scenario, Dr. Ettner said he's in the midst of a six-months-and-still-counting fight with one plan over payment for a mere office visit.

Dr. Ettner's experiences, and the experiences of many other doctors, are being confirmed by a newly released health-plan ranking system that breaks down which insurers are the most responsive to physicians, and which are not.

Athenahealth, a Watertown, Mass.-based claims processing company, developed what it calls the PayerView ranking system, which can be viewed online (www.athenapayerview.com). The system ranks plans based on seven categories, including days in accounts receivable, denial rates and first-pass pay rates.

Those numbers are converted into an overall metric used to rank plans nationally and regionally, as well as ranking Medicare- and Medicaid-based plans. The plans also are ranked based on their performance in each of the seven categories.

Kim LaFontana, Athenahealth's vice president, said the company wanted to use the data to let the insurers know what it's like to do business with them. Athenahealth plans to use the information to work with insurers on problem areas -- and also, perhaps, drum up a little physician business for its practice management services along the way.