MIAMI -- A federal judge approved an estimated $470 million agreement Friday between Aetna Inc. and the nation's doctors to settle claims that the company routinely skimped on payments to 950,000 doctors.

Judge Federico Moreno of the U.S. District Court for the Southern District of Florida had given preliminary approval to the settlement in May. Active and retired doctors who file claims could collect $55 to $165 each without submitting any supporting papers.

Doctors' attorneys estimate payouts could be as little as $75 million out of a $100 million refund fund. Any balance would be added to $20 million Aetna agreed to give to a health care foundation.

The managed care industry leader will use most of the settlement -- $300 million -- to implement internal changes to process doctors' claims for reimbursement more quickly. Attorneys will collect $50 million in fees.

"This agreement will reduce administrative complexity and lead to changes in the health care system that will ultimately benefit patients," John W. Rowe, chairman of Hartford, Conn.-based Aetna, said in a statement.

"I think that we have done the best that we could do," doctors' attorney Archie Lamb said. Mr. Lamb said the vast majority of doctors endorsed the terms of the agreement. Objectors could appeal.

In their racketeering lawsuit against Aetna, doctors contended they were routinely shortchanged on their claims for services by a computerized system programmed to downgrade claims and discount them when several services were provided at the same time.

Aetna agreed to changes in its standards and committed to a 15-day turnaround on claims, matching the shortest requirement in state laws.

Aetna has 13 million members in its medical plans and processes 180 million claims a year. The company also has settled a parallel lawsuit by the nation's 147,000 dentists, who serve 11.3 million Aetna members.

Cigna previously settled a similar class-action lawsuit. Others remain against Anthem, Coventry, HealthNet, Humana, PacifiCare, Prudential, United and Wellpoint.