Friday, December 18, 2009

Medicare Denies Twice As Many Medical Claims As Private Insurers

According to the American Medical Association’s National Health Insurer Report Card for 2008, the government’s health plan, Medicare, denied medical claims at nearly double the average for private insurers: Medicare denied 6.85% of claims. The highest private insurance denier was Aetna @ 6.8%, followed by Anthem Blue Cross @ 3.44, with an average denial rate of medical claims by private insurers of 3.88%

In its 2009 National Health Insurer Report Card, the AMA reports that Medicare denied only 4% of claims—a big improvement, but outpaced better still by the private insurers. The prior year’s high private denier, Aetna, reduced denials to 1.81%—an astounding 75% improvement—with similar declines by all other private insurers, to average only 2.79%.
From "Medicare’s Refusal of Medical Claims Continues to Outpace Private Rate" by Mary Theroux on the Beacon blog. Read her complete blog post here.

1 comment :

  1. Alarming post. This is not with medicare but I have read the same thing about the private health insurance companies too. There is no specific reason for this situation but the trend shows that false claims and fraud done by people results in denial and more strictness followed by the carrier.