CHICAGO - Some health insurance companies rate doctors on their performance. Now doctors are turning the tables.

The American Medical Association (AMA) issued its first health insurance report card at the group's annual meeting Monday. The primary focus is on how quickly and accurately doctors get paid.

"Physicians are spending 14 percent of their total revenue to simply obtain what they've earned," said Dr. William Dolan, an AMA board member.

The report card is an effort to reduce the cost of claims processing to doctors and help them as they negotiate contracts with insurance companies, he said. The report card will help patients if it reduces administrative waste, Dolan added.

The report card compares Medicare and seven national commercial health insurers on the timeliness and accuracy of claims processing. It is based on a random sample drawn from 3 million claims. There are no grades like A, B and C, and many of the technical measures may not mean much to most patients. But business leaders and policymakers are interested in cutting an estimated annual $210 billion in wasted administrative claims processing costs, AMA leaders said.

UnitedHealthcare had the lowest rate of contract compliance, according to the AMA report. About 62 percent of medical services billed were paid by UnitedHealthcare at the contracted rate, compared with 71 percent for Aetna and 98 percent for Medicare.

UnitedHealthcare spokesman Gregory Thompson said UnitedHealthcare has improved its electronic claims systems and noted the AMA gave the company higher ratings on other measures.

Medicare performed better than the private insurers in most areas, said Dr. Lawrence Casalino, a University of Chicago health economist and former physician. Commercial insurance plans compete by promising employers that they are tough on holding down the cost of claims, he said.

"There's no question that administrative costs for doctors and the country would be a lot lower in a single-payer system," Casalino said in an interview after the meeting. But a market-based system has advantages of competition, choice and innovation, he said. "Are the benefits enough to justify the cost?"

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