Insurers denied around 17 percent of in-network claims for ACA Exchange plans in 2021, according to an analysis from Kaiser Family Foundation.
In the report, published Feb. 9, researchers analyzed transparency data for exchange plans offered on Healthcare.gov.
Payers that denied more than a third of in-network claims in 2021 include:
- Meridian Health Plan (Mich.)
- Absolute Total Care (S.C.)
- Celtic Insurance (Fla., Ill., Ind., Mo., N.H., Tenn., Texas)
- Ambetter Insurance (Ga., Miss., N.C.)
- Optimum Choice (Va.)
- Buckeye Community Health Plan (Ohio)
- Health Net (Ariz.)
- UnitedHealthcare (Ariz.)
The researchers compared the denial rates for payers who received more than 5 million in-network claims in 2021.
Here's how they stacked up:
- Celtic Insurance Company (Fla.) — 41.9 percent of claims denied
- BCBS Alabama — 22.6 percent of claims denied
- BCBS Texas — 20.1 percent of claims denied
- USAble Mutual Insurance Company (Ark.) — 18.2 percent of claims denied
- BCBS South Carolina — 17.3 percent of claims denied
- BCBS Illinois — 16.5 percent of claims denied
- BCBS Oklahoma — 16.2 percent of claims denied
- HealthKeepers (Va.) — 15.8 percent of claims denied
- BCBS North Carolina — 13.7 percent of claims denied
- Health Options (Fla.) — 13.3 percent of claims denied
- SelectHealth (Utah) — 12.9 percent of claims denied
- BCBS Florida — 10.7 percent of claims denied
- Oscar Insurance (Fla.) — 6.6 percent of claims denied
- Bright Health (Fla.) — 5.7 percent of claims denied
Read more here.