Blue Cross Blue Shield of Rhode Island retains its spot as the highest overall performing health insurer among ambulatory payers in an annual survey.

Aetna was the best in the Major Payer and National Commercial Payer segments. As usual, Medicaid plans litter the bottom with California's Medi-Cal dead last.

The study results come from the annual PayerView Rankings from athenahealth Inc., Watertown, Mass. The company offers outsourced billing/collections services bundled with practice management and electronic health records software. The vendor has conducted the survey for six years based on data accumulated from clients. Data in the study totaled 47 million charge lines in 2010 and $9 billion in services billed in 41 states from more than 27,000 providers.

Overall, health insurers in 2010 paid physicians on average one day faster and denied 5 percent fewer claims than in the previous year. Both metrics are down from 2009 when insurers paid physicians on average seven days faster and denied 12 percent to 18 percent fewer claims.

Insurers are ranked on days accounts receivables (how fast they pay claims), first pass resolve rate, provider collection burden, denial rate, ERA transparency (% of denial messages with clear explanations and next steps) and accuracy of eligibility responses.

Insurers completing the top 10 following BCBS Rhode Island, were Aetna and Aetna US Healthcare, Humana, United Healthcare, BCBS Massachusetts, HealthPartners, Medicare Part B of Washington, BCBS Ohio, BCBS Pennsylvania-Capital Blue Cross, and Medicare Part B of Oregon.

Results of the 2011 PayerView Rankings are available at athenahealth.com/payerview. Under "Overall Performance," click on individual payers to get their scores.

--Joseph Goedert

 

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