Jason

Anyone have any facts to back up this? Or is this just someones opinion?


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its claims, higher than any private insurer (Aetna was second, denying 6.80 percent of its claims), and more than double any private insurer’s average.

What’s fascinating is that The American Medical Association (AMA) has endorsed a public option, despite the fact that “some member physicians at the group’s annual meeting [in June] likened the notion to communism.”

The Obama administration repeats ad nauseum that we need a government option to “keep insurance companies honest” and to make sure they don’t deny anyone coverage. Well what does one say about the fact that Medicare denies more claims than private insurers?

http://blog.heritage.org/2009/10/06/...h-care-claims/

Drew1369

Yeah they linked the report in the first sentance...

click on report

or click here

http://www.ama-assn.org/ama1/pub/upl...reportcard.pdf

Tumbleweed36

I remember one day about five years ago sitting in the check-in area for the Lutheran Hospital at Fort Wayne, IN waiting for an x-ray on my shoulder previous to a rotor-cuff surgery. There was this older couple who were sitting nearby waiting on some tests demanded by their doctor previous to stomach surgery for cancer.

They were so distraught, because the tests that were mandatory (I overheard all of the conversation) by their doctor previous to the operation would not be paid for by medicare. They did not find this out until they reported to the Hospital for the tests and were informed they must pay for the tests if they have it.

The costs for the test was about $800 and they were discussing how they could possibly pay for it. They were clearly not wealthy or able to pay for the test, but could not have surgery without it.

My heart broke as they discussed what they were going to do to get the test done since they simply did not have the money and the operation seemed to be a case of life or death. I always think in a case like this "yet for the grace of God, there go I."

simpswr

I can only speak to my experience with medicare. I am now near the end of a year long catastrophic collapse of the right foot . . I have had two surgeries, multiple x-rays ( every two weeks at times ) two Cat Scans and one MRI 7 weeks of Home Nursing, and a month of PT. . all within hours of being ordered be the vet . . not one claim denied by medicare.

When I was in a corporate insurance program ( Aetna ) for 34 years i regularly had claims denied or only partially paid.

bruiser

And yet Aetna has a better record than Medicare.

simpswr

A lot seems to depend on the quality of the office staff . . if they know the "ins and outs" of Insuramce or Medicare, things seem to go smoothly . . if they do not and do not do the paperwork right, things seem to go less smoothly..

I am currently seeing four Doctors . . they know the rules and their staffs know how to work within the system. I have 'fired" several doctors because their staff was not up to the task and caused me to have to do a lot of their work . . both with Aetna and Medicare. I have more experiencee with Aetna ( 34 years ) and only two with Medicare. Medicare seems to take longer to pay the Dr.s but they can do alot to speed that up with proper paperwork.

I wonder how much of the Medicare "refusals" are poor paperwork and fruad?

Tumbleweed36

My guess is that a lot of it is. My mother's doctor is one who is great at knowing what they will do and what they won't. When he orders some tests, he works it so they are paid without a hitch, but a former doctor she had made a hastle every time we had a blood test, because it was denied by Medicare.

We would go to the hospital with her and sit there after being denied. When they (the hospital person ) would call the doctor (regular occurence) in the Hospital area, he would change the details and they would pay it. Therefore, in this instance, you could not blame it on medicare but a doctor who didn't know the rules.