Guess Which Medical Insurer Denies the Most Claims

ObamaCare is gonna be such a panacea.

According to the  2008 Health Insurance Report Card (PDF) released by the American Medical Association, the “carrier” with the highest percentage of denials is . . . Medicare. Does it still sound like we need to put the government in control of (or develop a public option to compete with) health insurance companies to prevent them from denying claims?

(Aetna, by the way, is now the primary insurer of Medicare)

Metric 12—Percentages of claim lines (i.e., records) denied  Description: What percentage of records submitted are denied by the payer for reasons other than a claim edit? A denial is defined as: allowed amount equal to the billed charge and the payment equals $0.

Source: NHXS

Payer Count of records Denied records Percent of claim lines

denied

Date range
Aetna 637,239 43,317 6.80% 03/01/2007 – 3/10/2008
Anthem 250,070 11,546 4.62% 03/01/2007 – 3/10/2008
CIGNA 263,728 9,060 3.44% 03/01/2007 – 3/10/2008
Coventry 20,487 590 2.88% 03/01/2007 – 3/10/2008
Health Net 4,975 193 3.88% 03/01/2007 – 3/10/2008
Humana 143,026 4,142 2.90% 03/01/2007 – 3/10/2008
Medicare 6,938,431 475,566 6.85% 03/01/2007 – 3/10/2008
UHC 1,127,691 30,177 2.68% 03/01/2007 – 3/10/2008

http://www.statehousecall.org/which-insurer-denies-the-most-claims

Just wait until the government trainwreck takes effect. Socialized medicine is going to be such fun.

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