I think it’s better to say top than bottom, since we usually rank the highest number at the top – which is united healthcare at 31%. This is also how it’s displayed in the article.
Bottom would be correct is if was “claim approval rate”
Here is the link if the one in the post isn’t working:
A provider gave an opinion at appointment on UH 10 + years ago.
Provider: “Hello. How are you doing today?”
Me: “Well, the large company I work for just switched us from BlueCross BlueShield to United Healthcare.”
Provider: {pause} “I’m sorry.”
Me thinking: “Well, damn. It is as bad as I’ve heard.”
Ouch. That question has been on my mind all day.
Mr. Huph: Sit down, Bob.
[He does, moving the 4th pencil. Huph re-aligns it and starts.]
Mr. Huph: I’m not happy, Bob. NOT….HAPPY. [He gets up.] Ask me why.
Bob: Okay. Why?
Mr. Huph: Why what? Be specific, Bob.
Bob: Why are you unhappy?
Mr. Huph: Your customers make me unhappy.
Bob: What, you’ve gotten complaints?
Mr. Huph: Complaints I can handle. What I can’t handle is your clients’ inexplicable knowledge of lnsuricare’s inner workings!! They’re experts! EXPERTS, Bob! Exploiting every loophole, dodging every obstacle! They’re penetrating the bureaucracy!!
Bob: Did I do something illegal?
Mr. Huph [begrudgingly]:…no…
Bob: Are you saying we shouldn’t help our customers?
Mr. Huph: The law requires that I answer no.
Bob: We’re supposed to help people!
Mr. Huph: We’re supposed to help OOOUUR PEOPLE!! Starting with our stockholders, Bob! Who’s helping them out, huh?!
I’m pretty sure this data is not representative of *all* claims they process, just a subset.
I used to work in an adjacent industry, and the fact they are using a limited sample of publicly available data tells you it’s an extremely biased sample.
How is the industry average 16% when most of the industry is above that?
Anthem is listed at 2nd (23%), which, good. But then BCBS is toward the bottom at 17%.
BCBS is a licensing federation. There are 33 licensees (Anthem is one). Most operate as local health plans in their state. Some have health plans in multiple states. And while they work together in allowing members to have access to a national network of providers and they are bound by the rules of the federation, they are not subsidiaries of the federation or divisions of the same corporation. They all have different financial and operating models, policies, executives, etc.
It’s just a pet peeve of mine when BCBS is represented as if it is a singular corporation.
This is why I wish Kaiser was available nationally
Doesn’t surprise me. I had my daughter as an emergency c-section and they had to keep her in the NICU for a month, and it was literally a year long battle to get UHC to cover her $120k stay, they kept saying that it was not medically necessary?? Left a horrible impression on my husband and I. I’m still traumatized by the whole affair
Oof. 32% That’s a lot of suspects.
Now do a chart of murdered CEOs and they’ll be at the top, justifiably
15 comments
Thanks for posting this. I feel that the hard facts speak for themselves. The US needs to stop these lobbyists from preventing national health coverage from happening. The reality is 67% of bankruptcies in the USA are medical related. (Source: https://www.cnbc.com/2019/02/11/this-is-the-real-reason-most-americans-file-for-bankruptcy.html)
I think it’s better to say top than bottom, since we usually rank the highest number at the top – which is united healthcare at 31%. This is also how it’s displayed in the article.
Bottom would be correct is if was “claim approval rate”
Here is the link if the one in the post isn’t working:
https://www.valuepenguin.com/health-insurance-claim-denials-and-appeals
Claim denial rates by insurance company
Claim denials
UnitedHealthcare 32%
Anthem 23%
Aetna 20%
CareSource 20%
Molina 19%
What’s crazy is only 1% of patients bother appealing their denials.
[https://www.iamthebottomline.com/knowledge-center](https://www.iamthebottomline.com/knowledge-center)
A provider gave an opinion at appointment on UH 10 + years ago.
Provider: “Hello. How are you doing today?”
Me: “Well, the large company I work for just switched us from BlueCross BlueShield to United Healthcare.”
Provider: {pause} “I’m sorry.”
Me thinking: “Well, damn. It is as bad as I’ve heard.”
Ouch. That question has been on my mind all day.
Mr. Huph: Sit down, Bob.
[He does, moving the 4th pencil. Huph re-aligns it and starts.]
Mr. Huph: I’m not happy, Bob. NOT….HAPPY. [He gets up.] Ask me why.
Bob: Okay. Why?
Mr. Huph: Why what? Be specific, Bob.
Bob: Why are you unhappy?
Mr. Huph: Your customers make me unhappy.
Bob: What, you’ve gotten complaints?
Mr. Huph: Complaints I can handle. What I can’t handle is your clients’ inexplicable knowledge of lnsuricare’s inner workings!! They’re experts! EXPERTS, Bob! Exploiting every loophole, dodging every obstacle! They’re penetrating the bureaucracy!!
Bob: Did I do something illegal?
Mr. Huph [begrudgingly]:…no…
Bob: Are you saying we shouldn’t help our customers?
Mr. Huph: The law requires that I answer no.
Bob: We’re supposed to help people!
Mr. Huph: We’re supposed to help OOOUUR PEOPLE!! Starting with our stockholders, Bob! Who’s helping them out, huh?!
I’m pretty sure this data is not representative of *all* claims they process, just a subset.
I used to work in an adjacent industry, and the fact they are using a limited sample of publicly available data tells you it’s an extremely biased sample.
How is the industry average 16% when most of the industry is above that?
Anthem is listed at 2nd (23%), which, good. But then BCBS is toward the bottom at 17%.
BCBS is a licensing federation. There are 33 licensees (Anthem is one). Most operate as local health plans in their state. Some have health plans in multiple states. And while they work together in allowing members to have access to a national network of providers and they are bound by the rules of the federation, they are not subsidiaries of the federation or divisions of the same corporation. They all have different financial and operating models, policies, executives, etc.
It’s just a pet peeve of mine when BCBS is represented as if it is a singular corporation.
This is why I wish Kaiser was available nationally
Doesn’t surprise me. I had my daughter as an emergency c-section and they had to keep her in the NICU for a month, and it was literally a year long battle to get UHC to cover her $120k stay, they kept saying that it was not medically necessary?? Left a horrible impression on my husband and I. I’m still traumatized by the whole affair
Oof. 32% That’s a lot of suspects.
Now do a chart of murdered CEOs and they’ll be at the top, justifiably
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