October 5, 2009

Deny This: Guess Who Has the Highest Medical Claim Rejection Rate?

Filed under: Economy,Health Care,MSM Biz/Other Bias,Taxes & Government — Tom @ 11:55 pm

file-social-security-reconsideratioOh, 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:


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 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 NewsBusters.org.



  1. The more the public learns about government run healthcare, the less likely it is that we will see Obamacare pass. I hope enough people read the tea leaves on this pending disaster before it is too late.

    Comment by Jim Chase — October 6, 2009 @ 3:05 am

  2. your message about my “duplicate message” is an error on your part. you cut me off the first time before i was finnished.

    Comment by Jim Chase — October 6, 2009 @ 3:10 am

  3. Like every accountant knows, liars figure, but figures don’t lie. The question is, what is the strategy to get this in front of the state run media so they can’t miss seeing it. I know you have to cattle prod the hell out of them to get any action, but even they can’t be too blind to see this.

    Comment by Breast — October 6, 2009 @ 5:11 am

  4. #2, I’m sorry that WordPress did that to you.

    Comment by TBlumer — October 6, 2009 @ 6:35 am

  5. In addition, many of the other companies denials are “deductible amount” or “before/after covered period” where a large portion of Medicare denials are “we don’t cover that” or “we don’t think you should have done that.”

    Sign me up for gov’t-run HC, it was so awesome when I had Tricare!

    Comment by Scott — October 6, 2009 @ 7:17 am

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