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Thread: Guess Who Has the Highest Medical Claim Rejection Rate?

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    Re: Guess Who Has the Highest Medical Claim Rejection Rate?

    Quote Originally Posted by Agent Ferris View Post
    And did you ever stop to think that even though medicare covers less people than private insurance companies they still deny more people than private insurance companies?

    35 million people are covered by medicare whereas 200 million people are covered by private insurance companies and yet more people are still denied coverage by medicare.
    Why do you suppose that is? What conclusions can you draw about Medicare based on this fact?
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    Re: Guess Who Has the Highest Medical Claim Rejection Rate?

    Quote Originally Posted by Agent Ferris View Post
    That's right folks, medicare denies more sick people coverage then every single private insurance company combined. But hey by all means let's crush those evil insurance companies and vest our healthcare in the state. Obama, Reid, Pelosi you are sick ****ing jokes.
    Close to 7,000.000 Million "Disqualified"... I want B.O.'s "Health Care"....
    Last edited by Realist1; 10-07-09 at 10:02 PM.

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    Re: Guess Who Has the Highest Medical Claim Rejection Rate?

    Quote Originally Posted by Kandahar View Post
    Did you ever stop to think that maybe this is because Medicare has more sick people?
    Oh,so it's ok if the Government turns the sick away but not private insurance?
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    Re: Guess Who Has the Highest Medical Claim Rejection Rate?

    Quote Originally Posted by Kandahar View Post
    And is that because the big evil government is trying to pull the plug on grandma, or some other reason? Please, thrill me with your insight. Perhaps you could even respond to my previous post.
    Why would denial of coverage by medicare be based on a different criteria than the denial of coverage for private insurance companies?

    If the numbers in your graph are accurate, there were three times as many claims filed with Medicare as with all of those private insurance companies combined.
    And yet they still deny as a % they still deny claims .5% higher than the worst provider Aetna.

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    Re: Guess Who Has the Highest Medical Claim Rejection Rate?

    Quote Originally Posted by Strucky View Post
    Oh,so it's ok if the Government turns the sick away but not private insurance?
    If you have more sick people, of course it's more likely that more claims will be denied.
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    Re: Guess Who Has the Highest Medical Claim Rejection Rate?

    Quote Originally Posted by Kandahar View Post
    Why do you suppose that is? What conclusions can you draw about Medicare based on this fact?
    That they deny more people coverage than private health insurance.

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    Re: Guess Who Has the Highest Medical Claim Rejection Rate?

    This image makes me highly suspicious of the claim that 21% of private health claims in California are denied.

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    Re: Guess Who Has the Highest Medical Claim Rejection Rate?

    Quote Originally Posted by Kandahar View Post
    Really? So if I'm an elderly man who goes to a witch doctor who uses a voodoo doll to try to cure me, there's no excuse for Medicare denying my claim?
    Is that really the best argument you can come up with? I mean, no ****, really?



    Irrelevant to the subject at hand.
    It's very, very, very relevant to the subject at hand. All we've heard, to date, from the Libbos is how government insurance won't deny claims. Obviously that's not true.
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    Re: Guess Who Has the Highest Medical Claim Rejection Rate?

    Quote Originally Posted by Kandahar View Post
    If you have more sick people, of course it's more likely that more claims will be denied.
    But this is based on claims made and claims rejected and they still have a higher % of rejection. Obviously if you make a medical insurance claim you are sick or injured and if you're elderly you're probably more likely to be really sick and/or injured thus one should come to the conclusion that they should have less of a claim rejection % and yet they have a higher rejection %.
    Last edited by Agent Ferris; 10-07-09 at 10:12 PM.

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    Re: Guess Who Has the Highest Medical Claim Rejection Rate?

    Quote Originally Posted by Agent Ferris View Post
    Why would denial of coverage by medicare be based on a different criteria than the denial of coverage for private insurance companies?
    Because Medicare bureaucrats, unlike private insurance bureaucrats, don't have to worry about maximizing profits.

    Quote Originally Posted by Agent Ferris
    And yet they still deny as a % they still deny claims .5% higher than the worst provider Aetna.
    I can think of several explanations, none of which have anything to do with the big evil government wanting to pull the plug on grandma:

    1. More fraudulent claims are filed with Medicare then private insurers.
    2. Certain claims are specifically excluded from Medicare, but not from private insurers. (In which case it's silly to argue against the effectiveness of Medicare based on these denials, as the easy fix would be to end the exclusion.)
    3. If high cost medical claims are uniformly more likely to be denied, then it makes sense that the insurer with the most old and sick people would have the most denials.

    Unless you have some evidence that the circumstances of these claims and denials are all identical, you can't draw any meaningful conclusion from the data.
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