NCAAbbs

http://www.ama-assn.org/ama1/pub/upload/...rtcard.pdf
Denials (Payer allows the physician’s billed charge, but payment is $0)

Aetna 6.80%
Anthem BCBS 4.62%
CIGNA 3.44%
Coventry 2.88%
Health Net 3.88%
Humana 2.90%
United Healthcare (UHC) 2.68%
Medicare 6.85%

Deny This: Guess Who Has the Highest Medical Claim Rejection Rate?
By Tom Blumer
October 6, 2009 - 00:06 ET
http://newsbusters.org/blogs/tom-blumer/...ction-rate

Oh, the establishment press will just loooooove this -- not.

From BigGovernment.com (HT Mark Levin over the airwaves this evening):

Beverly Gossage, Research Fellow for Show-Me Institute and founder of HSA Benefits Consulting wondered which insurance companies rejected the most claims. She found her answer in the AMA’s own 2008 National Health Insurer Report Card (fairly large PDF).

I'm curious. Was it Aetna? Humana?

Well, well.

The Medicare denial rate found in the study was, on a weighted average basis, roughly 1.7 times that of all of the private carriers combined (99,025 divided by 2,447,216 is 4.05%; 6.85% divided by 4.05% =1.69).

You would think Medicare's sheer size might enable it to have smoother procedures with its providers that would enable it to turn down a lower percentage of claims. But no, this is the government we're talking about.

So who's the most "heartless" now? And why should Americans accept the idea of gradually being forced into a government-run system when, based on documented government experience, they will be more likely to see their claims denied?

And I didn't even get to the idea of refusals to treat in the first place, something that is present to some degree in virtually every state-run system, but is currently against the law in hospital emergency rooms in the U.S.

Come on now, you know that the big insurance companies just paid someone off for this survey. It is really a right-wing conspiracy.

This is GREAT NEWS FOR GOVERNMENT RUN HEALTHCARE. We can get all these percentages up higher and shoot for 10%, thereby reducing health care costs and killing Senior Citizens faster.

I would have guessed United Healthcare. It's one of the few (the only?) insurer that UAB doesn't accept.

I'd also be interested to see the numbers of physician offices that accept Medicare vs. Medicaid vs. the larger, more national insurance companies.

Since Medicare (Part A & B) is required for all 65 and older whether they have other insurance or not, and becomes their primary insurer if they do, they would get claims presented by doctors even in cases where they know they won't get paid. Who knows? They might get lucky. Claims are only presented for private insurers if a card issued by their company is presented by a patient, but everyone aged 65 and over has a Medicare card. If the doctor presents a claim each January when the annual deductible (mine is $135 and for younger patients it would be greater) must be met, everything up to the deductible will be denied. Private insurance won't cover that deductible gap either--they aren't even asked.