Interesting article in today's Times substantiating all the bellyaching over medical paperwork. Insurers, it turns out, don't like to pay claims. Better yet, sometimes they don't. The reasons range from denials of responsibility to calculated tardiness to lame protestations that they lost, or didn't receive, the papers, which were sent by certified mail. Estimates have the cost of following up on these arguments comprising about 20% of administrative costs at doctor's offices. Guess who ends up paying the difference?

Athenahealth decided to rank the various insurers. Humana, surprisingly, comes out on top, followed closely by Medicare. WellPoint ranked last. The insurers, for their point, argue that 40% of denials happen because of mistakes on the doctor's part -- an incorrect address, or a miscopied insurance card. But this stuff does matter. Take Pediatric Alliance, a consortium of 37 pediatricians around Pittsburgh. They spend "at least $250,000 a year on salaries for eight billing clerks who handle claims and pursue money owed by insurers and patients. That is on top of salaries in Pediatric Alliance's offices for staff members to verify the patient's coverage and collect co-payments, plus paying an outside company to check for errors before the bills go out." Yowch.

Most interesting is the graphic on the article's first page. I'm occasionally told that Medicare's dirt-cheap administration doesn't mean anything: they just approve all claims instantly. That's -- what's the word? -- crap. Medicare pays 92% of claims in full upon first submission. UnitedHealth pays 89.1%, Humana 87.7%, Aeta 86.7%, etc. They deny 8.9% of charges, more than Humana, Tricare, or Cigna. Add in that Medicare's spending growth is actually slower than the private sector's, and that's another attack on government-run insurance that withers under scrutiny.