Which Health Insurance Carrier Denies the most Claims?

Monday, October 5th, 2009 at 8:25 am

According to page 5 of the  2008 Health Insurance Report Card released by the American Medical Association, the “carrier” with the highest percentage of denials is…..Medicare. Does it still sound like we need to put the government in control of (or develop a public option to compete with) health insurance companies to prevent them from denying claims?


Metric 12—Percentages of claim lines (i.e., records) denied Description: What percentage of records submitted are denied by the payer for reasons other than a claim edit? A denial

is defined as: allowed amount equal to the billed charge and the payment equals $0.

Source: NHXS


Count of records

Denied records

Percent of

claim lines


Date range





03/01/2007 – 3/10/2008




03/01/2007 – 3/10/2008




03/01/2007 – 3/10/2008




03/01/2007 – 3/10/2008
Health Net




03/01/2007 – 3/10/2008




03/01/2007 – 3/10/2008




03/01/2007 – 3/10/2008




03/01/2007 – 3/10/2008
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The truth about COBRA subsidies

Thursday, October 1st, 2009 at 11:08 am

The eligibility rules for COBRA subsidy say “an employee who is terminated involuntarily (unless for gross misconduct)” is eligible. A client called to inform me that their company had two people who walked off the job who haven’t come back for days. Basically, “take this job and….” My client asked me if the company would have to offer COBRA and if these employees would receive the subsidy. When I called the Department of Labor office today to clarify what they meant by “gross misconduct” and “involuntary,” I was told that an employee would have to commit a felony to be considered gross misconduct and that an employee walking off the job and not coming back for days is not involuntary termination since the employer would have to make the decision to “take him off the books” for this behavior. So our tax payer dollars are going to subsidize COBRA premiums for pretty much everyone, not just those who were laid off due to the economy, as we were told.

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Stop Paying the Crooks

Friday, September 25th, 2009 at 7:42 am

With Medicare about to go bankrupt due to unfunded liabilities, shouldn’t we be focusing our attention to health care reform for Medicare. Listen to Jim Frogue, the author of Stop Paying the Crooks.

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Mandating Health Insurance is a Tax

Monday, September 21st, 2009 at 8:33 pm

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A Letter from Senator Brownback

Monday, September 14th, 2009 at 4:14 pm

We agree with his proposals for what health reform should include. See his last paragraph.

Dear Mrs. Gossage:

Thank you for sharing your thoughts with me on health care reform. There is no better guide to making tough decisions than hearing from those whom I serve.

Recent proposals to reform health care are disturbing. Government bureaucracies have no place in determining the health care plans available to the American people. Health care decisions should be made by patients and doctors, and I will do everything I can to maintain this relationship. As we have seen in other countries, a government-run system does not improve access to health care and leads to patients waiting months for treatment, and even traveling to other countries to receive care.
Read the rest of this entry »

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Response to comments on HSA article in St. Louis Dispatch

Sunday, September 13th, 2009 at 8:59 pm

Here is my response to the comments posted about the article “Personal HSA Plans May Yet Survive” by David Nicklaus on the St. Louis Dispatch website.

We should clarify the difference between health care and health insurance. There was a time when people bought the services of a physician directly. Health insurance (then called hospitalization) was bought cheaply on the market to only cover catastrophic claims. Read the rest of this entry »

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Medicare Should not be Our Example for Health Care

Friday, September 11th, 2009 at 7:37 am

Joe Antos of AEI and Grace Marie Turner of Galen Institute have a piece in the Wall Street Journal listing the top 10 reasons why Medicare should not be a model for health reform, starting with the fact that Medicare is going bankrupt. They conclude: Before we give the federal government authority over health coverage for tens of millions more Americans, shouldn’t the government prove it can do a better job with the “public plan” we already have?

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Fact Check of President Obama’s Speech to Congress

Thursday, September 10th, 2009 at 11:10 am

The St. Louis Dispatch online has a fact check article about President Obama’s speech to Congress. See the additional facts that I offered in my comment that they posted at the end of the article.

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Michael Cannon’s interview with National Review

Wednesday, September 9th, 2009 at 1:13 pm

A short interview worth reading.

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Freedom Fest 2009 video montage

Tuesday, September 8th, 2009 at 9:26 am

If you’ve never been to a “tax tea party” or a “freedom rally,” this video will give you a taste. These folks are worried Americans who come together to voice their concerns.

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