Tuesday, February 1, 2011
The California Nurses Association has issued a report revealing that California's largest health insurers denied on average of one out of four claims last year.
California A new report reveals California's largest health insurers denied on average of one out of four claims last year. The California Nurses Association issued the report.
The CNA says its findings are based on information health insurers provide to state regulators.
For the first three quarters of last year, insurance companies denied more than 13 million claims. PacifiCare led the way by initially rejecting nearly 44 percent of all claims. Anthem Blue Cross denied 27 percent of claims.
The CNA's Chuck Idelson said this industry-wide problem has been going on for a long time.
"We've tracked it back to 2002," Idelson said, "and there have been 67 million claims denied in California in the last eight years."
Insurers deny claims for a variety of technical reasons, saying the service provided was not a covered benefit, or the patient was no longer a member of the plan. Insurance companies say they pay most "eligible" claims.