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May 24, 2013
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Deny This: Guess Who Has the Highest Medical Claim Rejection Rate?

By Tom Blumer | October 06, 2009 | 00:06

A  A
Tom Blumer's picture
ClaimsDeniedChartOh, 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?

A chart showing the major carriers and how Medicare compared to them in the study follows:

DenialsByInsurer2008

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.

Cross-posted at BizzyBlog.com.

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