Study ranks TX payer performance

If you're a Medicaid provider in Texas, get ready to have your claims denied and your payments delayed. That's one of the conclusions drawn by a recent study of payers in Texas, conducted by physician practice management technology vendor Athenahealth. Athenahealth's Texas rankings, which analyzed claims performance for providers and medical practices from the second quarter of 2006, included 295,000 charge lines. Among other things, the study found that Texas Medicaid denied physician claims 23 percent of the time, and averaged 64 days in accounts receivable for claims it accepted. Among private insurers, Athenahealth found that Humana paid Texas physicians the fastest, with claims averaging 29.5 days in accounts receivable; Aetna was a close second at 30.2 days. The researchers also concluded that WellPoint affiliate UniCare Life & Health Insurance Company did the most of any private insurer studied to shift costs from insurer to patient.

Get more insight into the study's payer rating criteria:
- read the Athenahealth release

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