Anonymous
Anonymous asked in Politics & GovernmentPolitics · 1 decade ago

Did you know that Medicare denies more claims than the insurance companies everyone attacks?

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  • 1 decade ago
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    Rocky, you have made my day. ANYONE who has bothered to actually look into the health care mess would know that, thanks for being among the few on here that actually have some understanding of how it works..

    Private insurers for supplemental plans to medicare NEVER will pay anything medicare denies unless covered by separate riders.

  • Anonymous
    1 decade ago

    Those numbers are for over a year period and can not possibly reflect an accurate total denial rate as there is NO way the total claims can be correct. This study lists (for Example) Cigna having 263,000 claims in a little over a year period. Umm...Cigna had 11.4 MILLION members at the end of 2008. Cigna would have 263000 claims in a month or so period so how the heck does this study say they have that few claims in a year?

    Here is some rebuttal to that info...take it for what it is worth:

    http://www.dailykos.com/story/2009/10/6/05110/6076

    Take a look at a MUCH larger sample in California, over a 6 month period. A 10 day sample is just NOT large enough to get an accurate sample.

    http://www.calnurses.org/media-center/press-releas...

    Researchers from the California Nurses Association/National Nurses Organizing Committee analyzed data reported by the insurers to the California Department of Managed Care. From 2002 through June 30, 2009, the six insurers rejected 45.7 million claims -- 22 percent of all claims.

    For the first half of 2009, as the national debate over healthcare reform was escalating, the rejection rates are even more striking.

    Claims denial rates by leading California insurers, first six months of 2009:

    • PacifiCare -- 39.6 percent

    • Cigna -- 32.7 percent

    • HealthNet -- 30 percent

    • Kaiser Permanente -- 28.3 percent

    • Blue Cross -- 27.9 percent

    • Aetna -- 6.4 percent

    Additionally a KEY difference is Medicare takes EVERYONE even if they are sick or have pre-existing. Private insurance can deny anyone coverage for any reason, so their base population is not as sick. Also, I work with a Hospital application that processes Medicare and almost ALL Medicare denials are reviewed and then accepted. If private health insurance denies you, you are done.

  • Anonymous
    1 decade ago

    So why are all you cons defending Medicare?

    You need to stop listening to Stink Tank data.

    Medicare is not in the business of denying claims to people who need it for the rich's cadillac plans. It is fairly well known that medicare underpays, but the coverage covers a much broader section.

  • Anonymous
    1 decade ago

    have you ever seen what they try to get Medicare to pay for?

    ever see those comercials on TV... "Get a free hoveraround"... "get a free new diabetes checker"... "get a free new mechanical bed"

    companies prey on Medicare to try to get them to fund LITTERALY every crazy idea they come up with...

    they don't even TRY on regular insurance companies...

    so Medicare has all these insane denials that shouldn't have even been filed... while real insurance company denials are for actual care that people often need (not ALWAYS, but much fewer junk claims)

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  • Anonymous
    1 decade ago

    The Heritage Foundation is not a creditable source of information but aside from that it's bull to think they had access to that kind of information from private, for profit insurance companies. Medicare information like this, on the other hand, is public record.

    "Told you so" above is also correct.

    Source(s): .
  • Anonymous
    1 decade ago

    Yes, I did.

    Social Security will automatically deny everyone applying for disability, then you have to hire a lawyer to set up a hearing. It takes years for a disabled person to be declared disabled. The system is fundamentally flawed and there is no quick fix.

  • 1 decade ago

    You should read the actual report and not rely on another groups interpretation of it. Most groups will cherry pick information from reports to post that supports their agenda.

  • guiri
    Lv 7
    1 decade ago

    In that case, the insurance companies have nothing to worry about. Do they?

  • Anonymous
    1 decade ago

    Yes.

  • 1 decade ago

    Yes I do as I watch Glenn Beck!

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