Analysis of Variations in Claims Processing Costs of Fiscal Agents for the Civilian Health and Medical Program of the Uniformed Services

HRD-77-93: Published: Jun 8, 1977. Publicly Released: Jun 8, 1977.

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Wide variations exist in the claims processing costs under cost-reimbursable contracts of the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) because of the differences in administrative costs charged to the program, productivity, and wages of claim processors, claim volumes, and other factors.

Claims processing costs are higher than for Medicaid and Medicare, partly because of smaller claim volumes, a complex claim form, and frequent program changes. Differences in services provided by fiscal agents did not appear to be an important factor in the variances of the claim rates.

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