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.
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