Insurers Pay 90% Of Physician Claims Correctly; Medicare FFS Has Best Rate Of 99.5%

On average, health insurers pay 90.5% of physician claims accurately—with physicians receiving the wrong amount on 9.5% of claims. Medicare fee-for-service (FFS) had the highest payment accuracy rate at 99.5%. This was the result of a 2012 analysis of health plan payments by the American Medical Association (AMA). In 2011, health insurers had an average 83.5% payment accuracy rate.  Payment Accuracy Rates By Insurer, 2011 & 2012 Insurer 2011 2012 Aetna 81.1% 95.4% Anthem Blue Cross and Blue Shield 61.1% 88.6% Cigna 83.0% 90.6% Health Care Services . . .