The AMA did a study
and published it in 2008 and found that Medicare denied 6.85% of claims, a figure that is larger than any of the largest private insurance companies. It is also more than twice the average of all the private insurance companies.
Just something to consider when rallying behind a "public option" in any health care reform legislation. The current government-run government-provided health insurance denies more claims than any of the largest private insurance companies. I for one don't expect that to change with enlarging government's role in providing our health care.
"Of the eight insurers listed, Medicare is most likely to reject a claim, sending away 6.85% of requests. This is more than any private insurer and double that of the private insurers' average!
In short, the AMA is endorsing a plan whose closest existing example is the most frequent denier of claims. How the public option exemplifies "delivering care to patients" is unclear."--Big Government, 10/5/09
Oct 9, '09
by NRSKarenRN, BSN, RN Moderator
did you read the study? aetna also rejected 6.0 % of claim lines denied.
how about "percentage of claim lines reduced to $0 by edits" nr = not reported
united healthcare (uhc) 9.15%
on what percentage of records does the payer’s allowed amount equal the contracted payment rate?
united healthcare (uhc)
different picture now.
Last edit by NRSKarenRN on Oct 9, '09