Which Health Insurance Company Rejects The Most Claims?

FirefightnRick · October 6, 2009

MEDICARE????

AMA Endorses Largest Denier of Health Care Claims

What appears to be the official blog of President Obama’s administration is all aflutter because the President will welcome, “doctors from across the United States to the White House to share their unique perspective on the struggles that American families face every day when it comes to health care.” (They posted today’s agenda in the name of transparency!)
The post even links to a National Public Radio (NPR) story in which a survey of medical professionals indicates they are among the biggest supporters of the so-called “public option.” A co-sponsor of the study, Dr. Alex Federman, indicates that, “physicians favored Medicare when it came to delivering care to patients. They thought Medicare was better when it came to autonomy and their decision making and their ability to get patients the care that they thought the patients needed.”
............................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.

Rick

eeally · October 6, 2009

Rick,

The Health Insurance companies are so corrupt...I just give no merit to your post! I am sorry you favor greed over working class people. It is just weird! Good luck with it!

If they would make it simple.(No preexisting conditions) Earn 10%. Move on in ways that actually helped people then we would not need this debate. I agree to Tort reform if you will not bankrupt hard working families that have a heart condition.

Give me a compromise and let's take it to our congressman together working to help America....help people Rick.....Help them!!!!! God put poor people here to test you!!!! Now do the right thing! I know you have a huge heart and compassion!!!! Let your freak flag fly brother,,,,America needs your support to help those in need.

Peace and health to all .......

EE

eulesseagle · October 6, 2009

eeally, what is your solution? i personally do not think that the system was broke and needed repair. it is interesting to notice similarities how the clintons made health care reform their center piece in '92 much like obama is in '09. what happened in '94? looks like the same thing is about ready to happen again.

untbowler · October 6, 2009

Rick,
The Health Insurance companies are so corrupt...I just give no merit to your post! I am sorry you favor greed over working class people. It is just weird! Good luck with it!
If they would make it simple.(No preexisting conditions) Earn 10%. Move on in ways that actually helped people then we would not need this debate. I agree to Tort reform if you will not bankrupt hard working families that have a heart condition.
Give me a compromise and let's take it to our congressman together working to help America....help people Rick.....Help them!!!!! God put poor people here to test you!!!! Now do the right thing! I know you have a huge heart and compassion!!!! Let your freak flag fly brother,,,,America needs your support to help those in need.
Peace and health to all .......
EE

So where is the facts to back up the leftist talking points?

FirefightnRick · October 6, 2009

So where is the facts to back up the leftist talking points?

In case it was overlooked the facts reported above are found on the AMA's own website, which there is a link to it in the link I gave above.

But I like EE's idea of a letting my Freak Flag fly :lol: That's pretty good right there dude!

Rick

SilverEagle · October 6, 2009

I've never taken a statistics class, but I have to wonder about comparing numbers so out of purportion. The closest number to the medicare numbers (6.9mil) is 1.1 mil. Plus, what catagories of denial are we talking about? I know from personal experience that one of the assumptions that people make is that medicare will pay for all seniors who are in a nursing facility.....it does not. So there is one catagory where the denial rate gets skewed, compared to the others.

Censored by Laurie · October 6, 2009

I've never taken a statistics class, but I have to wonder about comparing numbers so out of purportion. The closest number to the medicare numbers (6.9mil) is 1.1 mil. Plus, what catagories of denial are we talking about? I know from personal experience that one of the assumptions that people make is that medicare will pay for all seniors who are in a nursing facility.....it does not. So there is one catagory where the denial rate gets skewed, compared to the others.

Look man, Rick got an email with numbers and stuff...and it supported his already entrenched opinion...so its fact.

Reason and logic will only take you so far until the government starts killing your parents at 70 and forcing your daughter into a mandatory abortion.

Green P1 · October 6, 2009

Haven't tried the others but Aetna recently shot me down. Sure would be nice if a degenerative hip condition didn't preclude me from finding coverage in the current system. Am I an evil socialist?

Edited October 6, 2009 by Green P1

yyz28 · October 6, 2009

Look man, Rick got an email with numbers and stuff...and it supported his already entrenched opinion...so its fact.
Reason and logic will only take you so far until the government starts killing your parents at 70 and forcing your daughter into a mandatory abortion.

...ah yes, the old "if you can't debate the point, attack the messenger" trick. Bravo, CBL! Bravo! You sure blew the information presented out of the water with that brillint bit of debating. :rolleyes:

Silver Eagle - don't ALL insurance companies field claims for nursing home stays? I'm not debating your point, but I don't get it. Can you clarify? Seems to me any insurance company or system would be faced with nursing home claims from seniors.

bigrobdsp · October 6, 2009

health insurance companies operate on some of the smallest margins of any industry anywhere. If Health insurors were making tons and tons of money I promiss there would be a Bigrobdsp insurance company. They dont need anymore competition than the free market already gives them. Anyone who thinks that government interference with the free market will lower costs had to sleep right through freshman level econ on their way to a degree in ceramics. Any industry that we want to become more competitive just needs to be fed to the free market. Any fat left in it will be imediatly loped off by plain old fashioned capitlolism. you want cheaper health care? cancel all goverment health programs. that will cheapen things up in about 2 hours.

SilverEagle · October 6, 2009

...ah yes, the old "if you can't debate the point, attack the messenger" trick. Bravo, CBL! Bravo! You sure blew the information presented out of the water with that brillint bit of debating.
Silver Eagle - don't ALL insurance companies field claims for nursing home stays? I'm not debating your point, but I don't get it. Can you clarify? Seems to me any insurance company or system would be faced with nursing home claims from seniors.

No they don't. My insurance company (blue cross) sent me some information about taking out "extended care" insurance, which would be separate from my regular policy. Kind of like buying a home and assuming that your homeowners policy automatically covers floods.........it doesn't.

Medicare (and I guess regular insurance companies) will cover someone who is in a nursing facility getting physical therapy. But that is a separate wing from the "regular" nursing home general care population. You are allowed only so many days in that physical therapy wing.

Medicare will only cover someone in the "general care" population if they don't have any assets (or very little assets). Otherwise you are denied coverage for general care in a nursing home.

So out of 6.9 million people, there has to be a pretty significant number of people who have applied to medicare to cover general nursing home care only to find out that they have too many assests....and are therefore denied.

Censored by Laurie · October 6, 2009

...ah yes, the old "if you can't debate the point, attack the messenger" trick. Bravo, CBL! Bravo! You sure blew the information presented out of the water with that brillint bit of debating.

No...I personally don't give a damn enough to do the leg-work required to breakdown such a bulky statistic that was clearly presented in such a way as to elicit the ire of people whose minds have already been made up.

My comment was borne out of the fact that this is just another tired example of the same template discussion under the guise of "political discourse" that goes on over here. Someone, typically FFR or EE, gets a subscription email or reads their favorite blog...turns around and posts the information as the gospel (without actually conducting any of their own research...which since this topic seems to be of such great importance to them, you'd think they would...but since these kinds of articles are handcrafted to fit in with their previously held opinions, why would one question their methods)...then the same 10 or so folks hop on here in a circle-jerk of support...untbowler puts his little sick green face guy above his post, KRAM1 uses a bunch of exclimation points and you string together 12 capital letters in a row that apparently means something to every 12 year old girl on instant messanger but that I have to go and look up everytime in order to have some semblance of the point you're trying to convey...and everyone walks a way feeling smarter without having actually learned anything.

UNT90 · October 6, 2009

Reason and logic will only take you so far

I would love to hear your or eealy's reasons or logic behind the views that you guys have. I don't think I have ever seen them posted. Not that this surprises me.

TheTastyGreek · October 6, 2009

health insurance companies operate on some of the smallest margins of any industry anywhere.

Grocery stores float on less than 1%, or at least they did as little as 6-7 years ago.

Their margins are so slim, a rash of shoplifters can tilt a store into the red.

UNTflyer · October 6, 2009

Rick,
The Health Insurance companies are so corrupt...I just give no merit to your post! I am sorry you favor greed over working class people. It is just weird! Good luck with it!
If they would make it simple.(No preexisting conditions) Earn 10%. Move on in ways that actually helped people then we would not need this debate. I agree to Tort reform if you will not bankrupt hard working families that have a heart condition.
Give me a compromise and let's take it to our congressman together working to help America....help people Rick.....Help them!!!!! God put poor people here to test you!!!! Now do the right thing! I know you have a huge heart and compassion!!!! Let your freak flag fly brother,,,,America needs your support to help those in need.
Peace and health to all .......
EE

You do realize some plans are non-profit, right? You really need to get your facts straight about insurance companies.

Blue Cross and Blue Shield of Texas is non-profit, I've been with them for 11 years, I've never had a claim denied, and they accepted my ex-wife's pre-existing condition.

If people are poor, there is Medicare, Medicaid, SCHIP, and charity organizations. If you want to do more to help the poor above and beyond these other programs you pay for, donate to a medical charity. But stop trying to take MY money to pay for people who make little or no effort to improve their lives.

Censored by Laurie · October 6, 2009

I would love to hear your or eealy's reasons or logic behind the views that you guys have. I don't think I have ever seen them posted. Not that this surprises me.

Once again, and not that this surprises me, you've failed to grasp the crux of my argument. I personally don't care about the issue enough to put in the time or effort needed in order to form an informed opinion.

You'll also notice that at no point did I say that the numbers were not factual...I actually imagine quite to the contrary...what I did say is that without any sort of support or analysis of those numbers that they don't mean shit...its simply another example of taking numbers, because "numbers do not lie", manipulating them and then turning around and presenting it as fact...its piss poor reason and logic.

Think of it like NFL films...they can make last year's Detroit Lions look like Super Bowl contenders without telling a single lie...that doesnt make it factual.

SilverEagle · October 6, 2009

"But stop trying to take MY money to pay for people who make little or no effort to improve their lives. "

Seems like I saw a similar statement in print last year from students who opposed the student service fee being raised. And it seemed like the "people who make little effort" they were talking about were the alumni who wanted a new stadium, but were not willing to pay for it themselves.

Maybe I just imagined it. :rolleyes:

Censored by Laurie · October 6, 2009

But stop trying to take MY money to pay for people who make little or no effort to improve their lives.

Poor = Lazy.

That right there is the irreconcilable difference of opinion behind the bulk of these discussions. Shame.

GreenMachine · October 6, 2009

then the same 10 or so folks hop on here in a circle-jerk of support

and the same 10 or so folks hop on here in a circle-jerk of opposition.

UNT90 · October 6, 2009

Once again, and not that this surprises me, you've failed to grasp the crux of my argument. I personally don't care about the issue enough to put in the time or effort needed in order to form an informed opinion.
You'll also notice that at no point did I say that the numbers were not factual...I actually imagine quite to the contrary...what I did say is that without any sort of support or analysis of those numbers that they don't mean shit...its simply another example of taking numbers, because "numbers do not lie", manipulating them and then turning around and presenting it as fact...its piss poor reason and logic.
Think of it like NFL films...they can make last year's Detroit Lions look like Super Bowl contenders without telling a single lie...that doesnt make it factual.

In your initial post, there was no argument, just a typical smart #$% remark. That's my point. If you want to debate something, then debate it respectfully and bring a counter point, or counter stats to the argument. This whole semi-comedy / personal attack routine is old.

Your no David Letterman, sir

FirefightnRick · October 6, 2009

I personally don't care about the issue

Obviously you do.

what I did say is that without any sort of support or analysis of those numbers that they don't mean shit...its simply another example of taking numbers, because "numbers do not lie", manipulating them and then turning around and presenting it as fact...its piss poor reason and logic.

American Medical Association 2008 National Health Insurer Report Card. Click and scroll down to page 5.

...the American Medical Association (AMA) has endorsed the public option after an appeal from the President....

No one has manipulated the numbers as they come from the same group of people Obama was parading in front of the campaign camera's yesterday.

Rick

TheTastyGreek · October 6, 2009

Nobody manipulated the numbers.

The numbers are consenting adults, and the numbers knew exactly what they were doing in that report.

If they didn't want to be cited, they wouldn't have drunk so much, and they DEFINITELY wouldn't have left the house dressed the way they did.

I think it's time for the numbers to start taking a little responsibility for themselves, and recognize that their choices have consequences.

Shuke-D · October 6, 2009

and the same 10 or so folks hop on here in a circle-jerk of opposition.

Wow. Dueling simultaneous circle-jerks. So we're making a sandwich here at the end of the day? I am quite sure the SGA will vote down this proposal as well.

forevereagle · October 6, 2009

Looking at the data, it appears that you cannot make a complete determination of the full performance of Medicare. There are a lot of reasons that are around missing information or bundled services. There is no statement about refiling and what percentage of these were refiled and accepted. Let's not just condemn the entire system because of incomplete data.

Edited October 6, 2009 by forevereagle

hickoryhouse · October 6, 2009

Nobody manipulated the numbers.
The numbers are consenting adults, and the numbers knew exactly what they were doing in that report.
If they didn't want to be cited, they wouldn't have drunk so much, and they DEFINITELY wouldn't have left the house dressed the way they did.
I think it's time for the numbers to start taking a little responsibility for themselves, and recognize that their choices have consequences.

I told those numbers at least twice to watch out who they were hanging out with.... I blame the fractions, if they hadn't come around none of this would have happened...