“We plan to continue developing innovative tools and capabilities that simplify administrative processes, allowing providers to spend more time with their patients.”
athenahealth announced the rankings in the 2015 PayerView® ReportTM, an annual report that measures payers’ financial, administrative and transactional performance, and also leverages athenahealth’s cloud-based data across its national network of health care providers. The PayerView data set analyzes 145 million charge lines and $28.5 billion in health care services billed in 2014.
“The PayerView ranking is a reflection of Humana’s ongoing efforts to improve providers’ experience and make it easier for them to provide patient care,” said Caraline Coats, Humana’s Vice President of the Provider Development Center of Excellence. “We plan to continue developing innovative tools and capabilities that simplify administrative processes, allowing providers to spend more time with their patients.”
In addition to its strong ranking in overall performance, Humana is the only national commercial payer in the Top 10. The company was also ranked number one in PayerView for the following measures among major payers:
- Eligibility Accuracy – Measures how well the payer’s eligibility of benefits transaction predicts the outcome of a claim.
- Enrollment Efficiency – Measures ease with which providers enroll in an electronic transaction with the payer.
- Provider Collection Burden – The percentage of charges transferred from the primary insurer to the next responsible party. Includes co-insurance, deductibles and other transfers (e.g., non-covered services).
- ERA Transparency – The percentage of electronic remittance advice (ANSI 835) denial messages with actionable explanations and clear next steps. This metric reflects how well payers adopted the standard code set by returning clear adjustment reason codes accompanied by remark codes as appropriate.
“PayerView’s evidence-based insight reveals how payers are succeeding and faltering across the United States,” said Todd Rothenhaus, Chief Medical Officer, athenahealth. “athenahealth is pleased to see Humana maintain its strong performance. As the industry enters a period of profound transformation, we hope that more payers will use PayerView to inform their initiatives and help providers successfully navigate change.”
The 2015 athenahealth PayerView report marks the seventh time that Humana has been ranked number one among major payers in the ten-year history of the athenahealth PayerView rankings.
In its 10th consecutive year, athenahealth PayerView results rank commercial and government health insurers according to specific measures of financial, administrative and transactional performance. These measures provide an objective, comparative benchmark for assessing how easy or difficult it is for providers to work with payers. Rankings are derived from athenahealth’s athenaNet® database, which includes more than 64,000 providers across 50 states.
View athenahealth PayerView findings at www.athenahealth.com/Payerview.
Humana Inc., headquartered in Louisville, Kentucky, is a leading health and well-being company focused on making it easy for people to achieve their best health with clinical excellence through coordinated care. The company’s strategy integrates care delivery, the member experience, and clinical and consumer insights to encourage engagement, behavior change, proactive clinical outreach and wellness for the millions of people we serve across the country.
More information regarding Humana is available to investors via the Investor Relations page of the company’s web site at www.humana.com, including copies of:
- Annual reports to stockholders;
- Securities and Exchange Commission filings;
- Most recent investor conference presentations;
- Quarterly earnings news releases;
- Replays of most recent earnings release conference calls;
- Calendar of events (including upcoming earnings conference call dates and times, as well as planned interaction with research analysts and institutional investors); and
- Corporate Governance information.
Humana Corporate Communications
Jeff Blunt, 513-826-7094